Physicians in the Westmed Medical Group reduced hospital admissions among their patients by more than 35 percent and the Purchase-based group practice reaped more than $300,000 in incentive payments in the first year of its collaboration with Aetna Inc. in a comprehensive health care program.
In a joint announcement, Aetna and Westmed officials said the success of their patent-centered medical home program ”“ a key model for the nation”™s health care reform efforts to lower costs while improving the quality of medical care ”“ has led them to expand their collaboration to include patients insured through Medicare.
A medical home is a team of doctors and clinicians within a medical practice who work together to provide continuous and comprehensive health care for patients. By providing ongoing attention to each patient, rather than episode-based treatment, doctors in a medical home can provide more efficient and more effective care, the health care partners said. Health plans such as Aetna support the practice with relevant patient care data, analysis and quality measurement along with financial rewards for improved quality of care.
In addition to curbing hospital admissions among 5,650 Aetna members, Westmed doctors met or exceeded 9 of 10 targeted goals on cancer screenings, diabetes management and screening, and heart disease management and screening, according to the program partners. Patients in the medical home program also made fewer visits to the emergency department and required fewer readmissions to hospitals. Patients also increased their use of generic prescription drugs instead of more costly brand-name drugs.
“Doctors often talk about quality, but don”™t measure it,” said Dr. Simeon Schwartz, founding president of the 260-physician Westmed Medical Group. “One of the key characteristics of the medical home is that it brings rigorous measurement and quality analysis to prove that the best care is being provided, resulting in fewer hospitalizations and medical errors.”
Dr. Barney Newman, medical director at Westmed, in the joint press release said the medical home program is designed “to really re-establish and enhance the role of the patient”™s primary care physician as the central coordinator of care, repository of information and the lifelong medical partner who delivers compassionate, continuous and coordinated care to the patient.”
Aetna is implementing a Medicare provider collaboration model with Westmed that will serve more than 650 of the insurer”™s Medicare Advantage plan members. Aetna officials said the company”™s nurse case managers will work closely with Westmed physicians to identify, coordinate and improve the care of elderly patients with complex health care needs and ensure adherence to best practices and treatment plans.
