The Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) has awarded a $1.2 million grant to Michigan State University to evaluate the effectiveness of primary care transformation efforts at Priority Health and Independent Health, a New York plan (see also Priority Health).
'The research will compare the effectiveness of two different patient-centered medical home (PCMH) strategies on improvement in outcomes including cost, quality and experience in pilot practices,' said Rebecca A. Malouin, Ph.D., M.P.H., director of the Primary Care Research and Evaluation Program at the Michigan State University College of Human Medicine.
PCMH is a model of care that replaces episodic care with a long-term physician-patient relationship focused on coordinated, accessible, comprehensive care. Attributes of the medical home include access to care, patient engagement and team-based care.
Malouin's research will evaluate the effectiveness of the PCMH pilots of Priority Health and Independent Health, a health benefits company in Buffalo, New York. The research will assess the advantages and disadvantages of each pilot on patient experience, cost, quality and outcomes. The three-year grant will analyze claims data from the pilot practices of each plan from 2009, when the pilots were launched, through 2011.
Priority Health and Independent Health offer an ideal comparison opportunity since both are community-based health plans (members of the Alliance of Community Health Plans), which began pilot projects in 2009. Both projects have common evaluation data elements but the two have differing approaches: Priority Health implemented payment reforms to encourage practice transformation and the adoption of improved access for primary care patients. In addition, Priority Health offered grant opportunities to primary care practices to facilitate transformation with consultative services from an external expert for a small subset of practices. Independent Health provided monthly prospective payments to practices to support implementation of specific structures and processes and annual retrospective payments based on the achievement of quality measures. Independent Health provided facilitated support from experts within the plan to each of its pilot practices.
Malouin was invited by AHRQ to present an overview of her research proposal at the agency's annual conference held in September in Bethesda, Md. 'It's the strength of our collaborative approach that made the project exciting,' she said. The project involves investigators from both the public (MSU) and private sector (Priority Health, Independent Health and ACHP).
HHS announced the grant as part of the investments made under the American Recovery and Reinvestment Act of 2009, which included $1.1 billion to support patient-centered outcomes research. About Priority Health: Priority Health is an award-winning health plan nationally recognized for creating innovative solutions that impact health care costs while maximizing customer experience. It offers a broad portfolio of products for employer groups, individuals and Medicare and Medicaid. As a non-profit company, Priority Health serves more than 600,000 people and continues to be rated as one of America's Best Health Plans by U.S. News & World Report and the National Committee for Quality Assurance. Learn more at priorityhealth.com. About Michigan State University College of Human Medicine: Founded in 1964, Michigan State University College of Human Medicine was among the first community-based medical schools, with a curriculum that emphasized a patient-centered philosophy. As a community-based medical school, the College of Human Medicine provides students with comprehensive training in clinical settings that most closely parallel the environment in which many physicians practice. During the third- and fourth-year of the program, students complete a series of required and elective clerkships at one of MSU's eight community-based program sites. The sites are located in Saginaw, Midland, Flint, Grand Rapids, Kalamazoo, Lansing, Traverse City and the Upper Peninsula. Visit humanmedicine.msu.edu.
Keywords: Legal Issues, Priority Health.
This article was prepared by Managed Care Weekly Digest editors from staff and other reports. Copyright 2010, Managed Care Weekly Digest via NewsRx.com.
