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September 2009 Issue

Craig Brammer (left), of the public health sciences department, and Robert Graham, MD (right), of family medicine, will lead UC’s participation in a national pilot program aimed at improving health care.
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Program Focuses on Increasing Doctor's Time, But Cutting Costs

By Katie Pence
Published September 2009

Disconnect within a health care setting is a reality—and a major problem.

Patients may see their doctors once a year for only a brief visit, leaving room for misinterpretation of instructions or an opportunity to ignore suggestions for follow-up or preventative care.

Now, UC internal and family medicine faculty members are taking steps to create a cohesive plan for managing patient care in addition to cutting costs.

This model—the Patient-Centered Medical Home pilot—will involve a total of 11 primary care practices in the Greater Cincinnati area and is being supported by the Greater Cincinnati Aligning Forces for Quality (AF4Q), an initiative of the Health Improvement Collaborative of Greater Cincinnati.

“This model is an approach to providing comprehensive primary care while facilitating partnerships between patients, their families and physicians,” says Robert Graham, MD, professor of family medicine and chair of the Patient-Centered Medical Home Work Group, a part of the AF4Q program.

“Medical care in the U.S. has become fragmented and not responsive to patients’ needs for coordinated care.

“We hope this broad approach will allow better access to care, increase satisfaction and improve health as a whole.

“We’re pleased that UC’s primary practices are part of this important, leading-edge program.”

The pilot will focus on disease prevention and maintenance of good health with primary care physicians
coordinating care with specialists to tailor care to a patient’s specific needs.

Patients will have access to a medical home team that knows their histories and will help them navigate the health care system and work on proactive health measures to stop disease before it starts.

The practices—consisting of 35 physicians—will serve approximately 30,000 local patients and will be paid an additional care management fee for about one-third of their patients. Anthem Blue Cross and Blue Shield, Humana Inc., UnitedHealthcare of Ohio and several employers are supporting the pilot.

The model is founded on the idea that by paying these doctors for the services patients value most, they will have the ability to give more time and attention to their patients, helping to avoid unnecessary and expensive tests, hospitalizations and emergency visits, and ultimately saving money for insurers, employers and patients.

“With this medical home pilot in place, the hope is that that we can see more patients while providing better care,” says Manoj Singh, MD, a family medicine physician with UC Health.

“We’re constantly on a treadmill where we are pressured to see more and more patients,” he continues. “This will hopefully take some of that pressure away and will allow us to truly focus on the health of the patient to provide better quality of care.”

The effectiveness of the model will be carefully evaluated by Meredith Rosenthal, PhD, in the Harvard School of Public Health. She will assess practice data generated during the pilot.  

“This pilot is one of very few across the nation that is bringing multiple health insurance companies, employers and providers together to focus reimbursement on prevention and health maintenance rather than responding to acute illness,” says Craig Brammer, senior research associate in UC’s department of public health sciences and director of Cincinnati AF4Q.

“With a national focus on health reform, it’s important to note that innovative, locally driven efforts are often the basis for the kind of health care transformation that ultimately needs to happen.” 

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