Priority Health, the Michigan State University College of Human Medicine and a New York health plan are collaborating on a ground-breaking study of the effectiveness of patient-centered medical homes in primary care.
A $1.2 million grant from the Department of Health and Human Services’ Agency for Healthcare Research and Quality to MSU will support the study to be led by Rebecca A. Malouin, director of the MSU-CMH’s Primary Care Research and Evaluation Program.
Malouin said she and her team will interview physicians and staff, survey patients, review quality metrics, outcomes and costs using claims databases, covering 2009-11, from Grand Rapids-based Priority Health and Independent Health, a Buffalo, N.Y. health plan. The team includes four MSU researchers and three health plan representatives.
The study will compare results from the two health plans nose to nose, which is an unusual aspect to the research, she said.
“This is an exciting time in health care, and everyone wants to know what works,” Malouin said.
Primary care practices have been working toward becoming “patient-centered medical homes” that use a comprehensive, team approach to treating patients and that leverage electronic medical records and other technology to integrate care with specialists and hospitals.
Insurance companies, including Blue Cross Blue Shield of Michigan and Priority Health, have invested in helping doctors’ practices become patient-centered medical homes with higher reimbursements and other support.
At Priority Health, reimbursements were enhanced to encourage primary care practice to adopt patient-centered medical home practices, including improved access for patients, such as extended office hours. The health plan, which is majority-owned by Spectrum Health, also provided grants for some practices to cover the cost of external consultants.
Independent Health used a different payment model, by providing prospective payments for specific changes in the medical practice and additional funds for meeting quality benchmarks. It provided its own experts to help practices make the changes.
Now is the time to measure whether the investment has paid off, said Dr. James Byrne, chief medical officer at Priority Health.
“The purpose of the study is to compare our health plan with Independent Plan of Buffalo to identify which tools, which processes actually created the best outcome,” Byrne said.“What things are the things we are doing that are causing success for our providers and our members, and what kinds of things are they doing? What works and what doesn’t?”
Results of the study will be published and become part of the evidence-based literature for others to learn from, he added.
“There are a lot of studies going on of primary care medical home pilots,” Malouin said. “Ours is the only one I’ve heard of where there is a comparison of two different approaches.”
The study began Sept. 30 and will last into 2013, she added. It is being funded through the American Reinvestment and Recovery Act of 2009, which allocated $1.1 billion for primary care research.