Two recent studies reveal that two of the latest concepts for reducing health care spending and improving health outcomes are doing what they were designed to do.
Blue Cross & Blue Shield of Rhode Island released a five-year, longitudinal study last week that showed patient-centered medical-home practices were 5 percent less costly than a standard primary care provider. At the same time, readmissions to hospitals were 30 percent less likely to happen, while the likelihood of emergency room visits or outright hospitalization for patients with serious medical conditions, such as diabetes or cardiac health issues, were 16 percent less than the standard.
Last month Coastal Medical revealed that it saved a combined $15.3 million in the last year through its accountable-care organization approach to patient care for both federal and commercial shared-savings contracts. According to Coastal, which is Rhode Island's largest primary-care practice, the ACO approach, which includes a team-based care model as well as its Coastal 365 clinic (which gives patients always-on access to Coastal resources), requires investment and a restructuring of operations, but the payoff can be great.
In fact, making the changes necessary to implement PCMH or ACO protocols requires significant investment, in people and in technology. But according to the Blue Cross study, the return on investment for a PCMH is 250 percent.
Continued study is required to confirm these results, but there is no question that the elusive "bending of the health care cost curve" is in sight. •