Group Health Cooperative in Washington state has been one of the early initiators of a patient-centered medical home demonstration project. The plan is a staff-model, meaning it generally employs the physicians members see and owns the hospitals used. Group Health took one of its clinics and converted it to the medical home model. An article in Health Affairs reports on results from the pilot after two years of operation. (Health Affairs Article)
Group Health added staffing, redesigned a care team approach and enhanced electronic record and communications capabilities as part of the process. Patient satisfaction was higher at this clinic, particularly in regard to coordination of and access to care. The gap between this model and usual care narrowed in the second year, but was still significant. Providers also had higher levels of work satisfaction at the medical home clinic, particularly in regard to burnout.
Clinical quality, as measured by HEDIS, was also significantly higher for the medical home pilot. Actual health outcomes do not appear to have been measured. There were fewer in-person visits with a physician, but more electronic communications. There were more specialty visits. There was less use of the emergency room and fewer hospitalizations. Overall, around $10 per member per month less was being spent, which is not a huge amount but if sustained over time could make a dent in cost growth. The return to Group Health after costs related to establishing and maintaining the model were $1.50 for each dollar spent. So far this appears to be a successful pilot. Extending it to other sites would help Group Health and policymakers see how replicable and sustainable its success is.