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Home / News & IndustryManaged Care Insight and Analysis
Updated: April 28, 2009
UnitedHealthcare, IBM And Arizona Physicians To Launch Healthcare Initiative

Physicians To Receive Incentives

UnitedHealthcare, a UnitedHealth Group company, and IBM unveiled plans for a collaboration with select primary care physician practices in Arizona to launch a transformative new healthcare initiative called the "patient-centered medical home" (PCMH) model.

Aimed at strengthening the primary care patient/physician relationship to enhance communication and service across the healthcare delivery system, the PCMH model provides comprehensive, information-supported primary care for children, youth and adults.

In the PCMH model, patients receive more comprehensive and coordinated care from their primary care physician or "medical home," rather than fragmented and episodic care from various healthcare providers or facilities operating without all the information needed to define a safe context for care.

In the PCMH model, primary care physicians partner with their patients to understand their needs and preferences, manage their healthcare and facilitate any care needed from other professionals. The model places special emphasis on preventing disease and improving the care of chronic conditions, and emphasizes behavioral health support and patient education – not simply the diagnosis and treatment ofinjury and illness.

The new pilot program – open to UnitedHealthcare’s employer-sponsored, Medicare Advantage and Medicaid health plan customers – will include 4-6 primary-care practices from UnitedHealthcare’s physician network in Phoenix and Tucson. UnitedHealthcare will provide the selected primary care practices with technology, infrastructure support and care coordination, with the goal of leveraging improved information systems to enhance patient access to care, the quality and safety of the care experience and patient satisfaction with healthcare providers.

IBM, with some 386,000 employees around the world, led in the formation of the physician-employer Patient-Centered Primary Care Collaborative in 2006, of which most major U.S. trade associations, consumer groups and leading health benefits and services companies are now members.

In 2007, IBM spent more than $21 million for Arizona employees and their dependents in health benefits costs.

UnitedHealthcare is IBM’s largest health plan in Arizona, serving nearly 11,000 beneficiaries. In support of the pilot, IBM will encourage these employees to seek primary care services from the physicians participating in the pilot program.

UnitedHealthcare and IBM expect the PCMH model of care will, over time, assist in lowering overall healthcare costs for patients and their employers by reducing emergency room visits, hospitalizations and disabilities that result from the lack of immediate access to primary care physicians when people have medical needs.

"UnitedHealthcare and IBM are committed to supporting primary care physicians through the patient-centered medical home model, which provides for more centralized and comprehensive care that is focused on preventive care and disease prevention," said Dawn Bazarko, UnitedHealthcare senior vice president of clinical innovation. "We believe the patient-centered medical home model enhances the delivery of higher-quality, more coordinated care, while improving outcomes and reducing healthcare costs."

The PCMH model of healthcare delivery provides benefits to physicians as well as patients. Primary care physicians providing care based on the PCMH model stand to receive enhanced reimbursement in recognition of superior care coordination and improvements to access, communications, delivery of preventive and chronic care, and patient experience and satisfaction.

Addresses: IBM Corporation, 1 New Richard Rd., Armonk, NY 10504; (800) 426-4968, www.ibm.com. UnitedHealth Group, 9900 Bren Rd. East, Minnetonka, MN 55343; (952) 936-1300, www.unitedhealthgroup.com.


  This article was taken from:
Pay-For-Performance Reporter

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