Cincinnati Recognized as Health Strategy Pioneer
| Bethesda Inc. accelerated TriHealth’s Patient Centered Medical Home initiative by providing significant grant money for implementation and also helped Cincinnati to demonstrate its collaborative focus on quality through a separate grant to the Health Collaborative. |
The following is a Cincinnati Business Courier Letter to the Editor, Originally Published May 18, 2012.
Written by Will Groneman, Executive Vice President, System Development, TriHealth.
The Cincinnati and Dayton health care communities have been chosen to pioneer new strategies in health care payment and delivery by the national Centers for Medicare and Medicaid Innovation (CCMI) for the Comprehensive Primary Care Initiative (CPC).
CCMI’s choice of this region included national recognition for our comprehensive health care transformation strategy and the active participation and successful collaboration of key health care stakeholder groups including health systems, commercial health plans, leading employers and consumer groups.
The CPC is investing up to $60 million in new Medicare funds over a four-year period for health care payment and delivery model innovation in comprehensive primary care approaches. In addition, our commercial insurance plans have committed to make similar investments.
This is not just another health care project. This effort has the potential to change the way health care systems provide medical care to patients. Patient health will improve and costs will be reduced. Most importantly, the work begins here, in our community, representing an exciting new level of collaboration between Medicare, commercial health plans and providers.
How did our region attract CPC funding? In large part due to the initiative taken by our health insurance providers and the key role of the Health Collaborative in teaming insurers with health care providers – building on our community’s long history of collaboration among stakeholders in health care delivery and financing.
The selected insurance plans had to formally commit to the partnership by funding up to 75 selected primary care practices in a similar manner. The insurance providers include: Anthem Blue Cross and Blue Shield, Buckeye Community Health Plan, HealthSpan, CareSource, Humana, Medical Mutual of Ohio, Ohio Medicaid and United Healthcare.
The CPC concept exemplifies “patient-centered” health care, because it aligns reimbursement incentives with doing what is right for the patient. This model focuses on keeping patients better by managing chronic diseases and coordination of care for those patients with complex medical problems. Practice sites will employ care coordinators to be conduits between the patient and the primary care physician to ensure wellness services are scheduled and delivered.
Primary care physician practices chosen to participate in the CPC will be expected to use the additional funding to better coordinate care for their patients including helping patients with serious or chronic diseases follow personalized care plans.
Here in Cincinnati, we have the opportunity to help drive a much-needed cultural shift in medicine by providing common goals focused on appropriate care for each patient rather than rewarding hospitals and physicians for simply treating more patients. TriHealth, for example, has been working hard to restructure our entire system to this patient-centered concept.
The CPC launches later in 2012. Our first year will likely focus on building infrastructure by providing additional payments on a per-member, per-month basis to physicians selected for the program. After that, per-member, per-month payments will be reduced and the focus shifts to physicians sharing in cost savings. Employers stand ready to reap the benefits.