Medical Home's Payoff Comes From Effort and Technology

Improved management of patients with chronic disease states has been an early success of the JHCP efforts. "New patients with a diagnosis of diabetes had a baseline hemoglobin A1C of 8.65," Kravet says. "After they had attended an educational class, their hemoglobin A1C came down to 6.56, and their most recent measure of 6.80 suggests that the improvement was sustained several months later.

Patients who the practices failed to recruit into the classes had essentially no change in hemoglobin A1C. "It's suggesting the power of patient engagement and improvement with group visits and education."

Achieving cost reductions
Reducing the healthcare cost medical loss ratio was another achievement of the pilot at Water's Edge. This figure declined from 86 percent in fiscal year 2010 to 83 percent in fiscal year 2011, and is estimated to drop to 78 percent in fiscal year 2012.

Now that clinical outcomes and cost reduction have been demonstrated, JHCP is turning its attention to issues of staff teamwork, job satisfaction, working conditions and perceptions of senior management. "Those measurements have all gotten worse over the past few years," Kravet says. "We've made the place busier. We haven't paid as much attention to the experience, which has now become our focus."