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Beyond the Medical Home

Greg Freeman, May 13, 2011
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Traditional methods of patient care are rapidly being eclipsed by a focus on patient-centered medical homes, accountable care organizations, and other strategies designed to improve care while saving money. But two groups in North Carolina say those trends don’t go far enough. They are launching a program that they promise will create a completely new type of medical practice.

BlueCross BlueShield of North Carolina is working closely with UNC Healthcare, a not-for-profit integrated healthcare system owned by the state of North Carolina and based in Chapel Hill at the University of North Carolina.

BCBSNC and UNC Healthcare expect the new practice to open in the fourth quarter of this year, says Don Bradley, MD, MHS-CL, the chief medical officer and senior vice president for healthcare for BCBSNC. The model can be seen as a cross between a PCMH and an ACO, taking both concepts beyond their usual iteration. Like a PCMH, it will encourage more preventive care and more collaboration among caregivers. Like an ACO, the model will strive to provide a comprehensive, holistic management plan for patients, Bradley says. But because the program
will work exclusively with BCBSNC members and UNC Healthcare, the cost savings will be realized without an ACO arrangement.

The physicians and other team members will all be salaried, Bradley explains, rather than having a fee-for-service system. Claims will still be made to payers, and the claims experience will help with data collection, but from a provider perspective the claims won’t impact their income, Bradley says.

“Having the team members on salary has been one of the key components of success for the ACO models, and we want to build on top of that by adding incentives around quality and outcomes,” Bradley says. “If there are financial gains or losses from the practice as a whole, those will be shared by BlueCross and UNC.”

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1 comments on "Beyond the Medical Home"


Robert Finney PhD (5/13/2011 at 4:21 PM)
Original investigation on Kaiser Permanente's covert human experiments, "100,000 Kidney Failure Patients Are HMO Lab Rats," is posted on http://www.hmohardball.com/100,000%20Kiddney%20Patients%20text.pdf and www.hmohardball.com. Robert Finney, Ph.D.