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Home / News & IndustryManaged Care Insight and Analysis
Updated: December 15, 2009
Medical Home Pilot For Diabetes Begun In South Carolina; Enrolls 1,110

Some 1,100 patients have been enrolled in a year-long medical home pilot project in South Carolina. Organizers believe the project could become a model for the state.

The focus of the ‘patient-centered’ pilot project is on diabetic patients who are patients of Palmetto Primary Care Physicians in the Charleston, S.C., area, and are members of either BlueCross BlueShield of South Carolina, BlueChoice HealthPlan of South Carolina, and the State Health Plan.

Palmetto Primary Care Physicians includes 57 providers and 350 employees in 19 clinics or offices in 11 locations.

The medical homes concept places the primary care doctor in charge of a team that can include social workers, pharmacists, wellness coordinators, nurses, disease managers, certified diabetic educators, dieticians and pharmacists all working together to proactively reach out and develop an individual treatment plan for patients.

Sixty percent of the eligible patients were contacted in the first three months of the program by case managers who were hired for the project. The managers worked with patients to explain the concept, gather baseline health data, and encourage patients to use an online portal that contains tools that helpmanage their disease and enables them to have "e-visits" with a physician.

Role of Case Mangers

Case managers are central to the success of the program. Their aim is to reduce gaps in care, such as missed appointments with specialists, and lifestyle issues such as medication adherence. Case managers also perform such outreach as registering patients for diabetic education, scheduling appointments with specialists, providing discount vouchers for medications, offering discounted memberships to local gyms, and monitoring quality processes and outcomes measures to help increase patient compliance.

"Our case managers have been calling patients who are eligible for the pilot project, and the patients absolutely love it. We’ve been able to provide patients with additional resources and education," said Jennifer O’Donnell, director of quality improvement for Palmetto Primary Care Physicians. "We are able to encourage patients to make diet and exercise changes as well as schedule appointments for their concerns before the problem gets worse."

There is no co-payment or extra charge to the patients for participation in the pilot.

Organizers of the pilot program are being invited to speak at meetings of various medical societies and business groups to describe the medical home concept and its potential, said Dr. Laura Long, BlueCross’ vice president of clinical quality and health management. She and Dr. Kirt Caton from Palmetto Primary Care Physicians addressed a recent meeting of the South Carolina Academy of Family Physicians.

"The goal is to reduce the disconnects in health care, improve quality of life for the patient, create tighter relationships and better communications, and add for the first time a focus on measurement of quality and continuous improvement of clinical outcomes," said Dr. David L. Castellone, president of the Palmetto Primary Care Physicians board of directors.

For more information on Blue Cross Blue Shield of South Carolina, visit www.SouthCarolinaBlues.com and for more information on Blue Choice of South Carolina, visit www.BlueChoiceSC.com

Address: Palmetto Primary Care Physicians, 5325 Appian Way, Charleston, SC 29418; (843) 552-0400, www.palmettoprimarycare.com.


  This article was taken from:
The Executive Report on Managed Care

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