Health Insurers, Colorado-based Non-profit Unveil Ground-breaking "Medical Home" Pilot Program


Contact: Julie Schilz
Telephone: (720) 297-1681

LAKEWOOD, COLO., June 18, 2009-Colorado Clinical Guidelines Collaborative (CCGC) and five of the nation's largest health insurers today announced the launch of one of the nation's largest medical home programs. Colorado's "Patient-Centered Medical Home" (PCMH) program will broadly validate the viability and effectiveness of the medical home concept - an idea currently gaining national prominence for its potential to improve health care quality and better manage costs.

The two-year Patient Centered Medical Home program involves five of the states largest health plans: Aetna, Anthem Blue Cross and Blue Shield, Cigna, Humana and UnitedHealthcare, along with Colorado Medicaid which will provide enhanced compensation (covering approximately 25,000 patients) for 17 Colorado internal or family medicine practice sites who have agreed to serve as patient-centered
medical homes to deliver expanded care and services to their patients. Participating practices will receive additional incentive payments for meeting high-quality benchmarks for patient care. The medical home concept is an innovative approach to health care that provides patients with comprehensive, coordinated care through a primary care team. The focus is on continuous care, both preventative and reactive treatments, with the aim of keeping patients healthier.
"The goal of the Medical Home is to provide patients with easy access to a personal health care team that knows who they are, what their history is and is dedicated to helping them navigate our complex healthcare system when they're sick and, more importantly, work with patients proactively to stay healthy. As it has been said, 'It's the kind of care you want your Mom to have'," said Dr. Marjie Harbrecht,, the Medical and Executive Director of CCGC.
The PCMH program also enhances the payment model for physicians as a way to encourage more personalized care for patients. Participating physicians will receive a standard fee for service, a monthly care management fee and a bonus for meeting or exceeding quality outcomes.
This blended payment model shifts the focus of care from episodic treatment toward comprehensive care, with more emphasis on preventing problems rather than waiting for them to happen. This has been shown to result in lower costs and better health outcomes. The payment model also allows for better coordination of care with all healthcare entities (i.e., the "medical neighborhood"), which is not paid for under the current system.
Colorado Clinical Guidelines Collaborative will serve as the convening organization and provide practice transformation support for the participating practices including in- office coaching, technology, and shared learning networks. Funding for the program was provided by The Colorado Trust who, along with The Commonwealth Fund and the Harvard School of Public Health, will also evaluate this demonstration project to improve primary care delivery by aligning high quality, coordinated care with financial
The Colorado Clinical Guidelines Collaborative (CCGC) is a unique nonprofit coalition of health plans, physicians, hospitals, employers, government agencies, quality improvement organizations, and other entities working together to reduce fragmentation and implement systems and processes, using evidence based clinical guidelines, to improve healthcare in Colorado.