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5 Big Ideas from WellPoint's PCMH Pilot

Margaret Dick Tocknell, for HealthLeaders Media, September 19, 2012

There is a time lag on some claims data, but Hummel says, "this is an example of when we can't let great get in the way of good. Even with the lag our information is better than what the physician has now."

WellPoint's pharmacy claims data is refreshed each night. Physician data is available within about two weeks. Hospital billing cycles contribute to a 30 to 60 day lag in making that information available to physicians.

4. Physician practices need help
Even with the money, coordination, and information, physicians practices need additional help making the shift to the new delivery model.

Transformation to the coordinated care model requires physicians to redesign how they deliver care in their offices. WellPoint is hiring patient-centered care consultants to help physicians learn the basic elements of patient centered care. "They need to understand how to interpret data, how to develop care plans, and how to develop strategies for frequent ER fliers," explains Hummel.

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1 comments on "5 Big Ideas from WellPoint's PCMH Pilot"


R V Cummings (9/19/2012 at 5:22 PM)
The Veterans Health System has considerable experience with the medical home model known in the VA as PACT (Patient Aligned Care Team). The experience has demonstrated the processes and staffing that lead to proactive care management.