An earlier trial of the model by UnitedHealth, in Florida, never got off the ground because doctors refused to participate. This time, however, the insurer is teaming up with seven doctors’ groups to make another attempt, in Arizona, at the prodding of one of the state’s big employers, I.B.M.
According to the the New York Times, UnitedHealth will try giving doctors more authority and money than usual in return for closely monitoring their patients’ progress, even when patients go to specialists or require hospitalization. The insurer will also move away from paying doctors solely on the basis of how many services they provide, and will start rewarding them more for the overall quality of care patients receive.
The new approach, which is also being tested in various guises by other insurers around the country, is known as the “medical home” model of health care. Many experts hope it will prove one of the best ways to rein in the nation’s runaway medical costs, while making people healthier. The theory is that by providing a home base for patients and coordinating their treatment, doctors can improve care, prevent unnecessary visits to the emergency room, reduce hospitalizations and lower overall medical spending.
Prodded by IBM, one of Arizona’s largest employers, insurer UnitedHealth Group has announced plans to launch a medical home pilot project involving seven physician groups in the state, the New York Times reports. Noting that the project brings UnitedHealth’s expenditures for medical home initiatives—including one in Colorado and another in Rhode Island—to more than $1 million this year, the Times reports that UnitedHealth attempted an experiment similar to the pilot in Arizona approximately 18 months ago in Florida—a project that ultimately failed. Incorporating lessons from the Florida project, the insurer consulted with Arizona physicians to create the pilot program and has hired a consultant—a for-profit unit of the American Academy of Family Physicians—to advise physicians on how to change their practices to adopt a medical home approach.