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Making Margin with the Medical Home

Karen Minich-Pourshadi, for HealthLeaders Media, September 13, 2011
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While the program began seeing success with its patient outcomes, Brown says the practice wasn’t sure how it would fare financially.

“Ultimately, what drives everything is money,” she says. “We’re in primary care so we had to do this on tight budget—it had to be budget neutral. But we did this pilot knowing there was zero going into it and we’d have to make it financially stable.”

Rather than hire additional staff, the practice redefined the roles of existing staff and provided new processes for them to use. For instance, the front office staff began checking to see if tetanus shots were due and administered them without a physician having to go through the file and request them. Tetanus was just one preventive care area the staff began to address; the overall attention to preventive care and immunizations caused a shift in the practice’s quality.

After laying the groundwork, the practice secured grants through process improvement proposals and the Partnership for the Enhancement of Regional Preparedness. It was about this time when a couple of the larger insurance companies in the area started paying providers incentives based on their own sets of quality measures.

 “As our quality metrics went up, it impacted us financially. The better we were, the more quality indicators we hit with the insurers, and our PIP and PERP grant money also went up.”

The teamlet approach also helped Brown and other practitioners see more patients per day. “It was great for our patients and it also hit my bottom line—I could see 3–5 more patients a day and that adds up over time,” she notes.

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