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Home / News & Industry / Managed Care Vendor Sales Insight
Updated: March 30, 2011
Geisinger Writes Own Script To Create Medical Home Program

Following up on a challenge from its board in 2005, Geisinger Health System (GHS), an integrated delivery system in Pennsylvania, launched in 2006 its own patient-centered medical home initiative program, rather than copying someone’s else’s program.

The thinking was driven by the realization that over time Medicare would have to limit premium payments for Medicare Advantage Plans. GHS had more than 35,000 Medicare Advantage members so this was a critical business issue, GHS said.

Centered on the coordination of care, the GHS program is patient-centered as opposed to provider-centered. It utilizes additional nurses in primary care offices to coordinate care and interact directly with individual patients.

When it developed its medical home concept, GHS believed it was important to start from scratch, reinventing the way care was delivered. To that end GHS identified five basic components central to the medical home concept:

  • Patient-centered primary care;
  • Population management activities that move many of the activities performed by the health plan to primary care offices;
  • Value care systems that extend care beyond primary care offices;
  • Implementation of a quality management system to measure patient outcomes; and
  • Additional payments to providers to encourage physician participation and engagement.

The health system hired a dedicated director for the initiative and spent approximately $500,000 in employee and leadership training time to prepare for the initiative. It invested approximately $3.5million in staffing and other expenses to get 11,000 members immediately enrolled in the initiative.

Today hospital admissions are down and patient satisfaction is up, GHS said.

Address: Geisinger Health System, 100 N. Academy Ave., Danville, PA 17822; (800) 2755-6401, www.geisinger.org.


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

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