UPMC Health Plan, Pittsburgh, Pennsylvania, USA.
Health Aff (Millwood). 2012 Nov;31(11):2423-31. doi: 10.1377/hlthaff.2011.1002.
The patient-centered medical home is a promising model for improving access to high-quality care for more Americans at lower cost. However, feasible pathways for achieving a transformation from current primary care practices to this new model have yet to be fully identified. We report on the experience of UPMC Health Plan-part of a large, integrated delivery and financing system headquartered in Pittsburgh, Pennsylvania-in its efforts to support primary care practices as they converted to patient-centered medical homes. From 2008 through 2010, sites participating in the UPMC pilot achieved lower medical and pharmacy costs; more efficient service delivery, such as lower hospital admissions and readmissions and less use of hospital emergency departments; and a 160 percent return on the plan's investment when compared with nonparticipating sites. We suggest approaches that could spur the adoption and spread of the model, including that payers be offered incentives to enter into patient-centered medical home contracts with interested providers; that payers increase efforts to provide primary care practices with access to usable data on their patient populations; and that telehealth be instituted to connect care managers to patients and practices when in-person visits are not possible or necessary.
以患者为中心的医疗之家是一个很有前途的模式，可以降低成本，让更多的美国人获得高质量的医疗服务。然而，要从当前的初级保健实践转变为这种新模式，可行的途径尚未完全确定。我们报告了宾夕法尼亚州匹兹堡总部的大型综合交付和融资系统 UPMC Health Plan 的经验，该系统努力支持初级保健实践向以患者为中心的医疗之家的转变。从 2008 年到 2010 年，参与 UPMC 试点的地点实现了更低的医疗和药品成本；更有效的服务交付，如更低的住院和再入院率，以及更少使用医院急诊部；与非参与地点相比，计划投资回报率为 160%。我们提出了一些可以促进该模式采用和推广的方法，包括向有兴趣的提供者提供激励措施，以签订以患者为中心的医疗之家合同；支付方加大努力，为初级保健实践提供其患者群体的可用数据；以及建立远程医疗，在无法或不需要进行面对面访问时，将护理经理与患者和实践联系起来。
