| Medical Home Concept Could Be Good Medicine For Pharma
The pharmaceutical industry stands to gain from the
patient-centered medical home concept gaining traction across the
country, said HealthLeaders-InterStudy, a provider of managed care
market intelligence.
The medical home concept relies on a team-based approach
where a primary care physician provides coordinated care throughout a
patient’s lifetime, ultimately reducing hospitalizations and
minimizing costs in the long run.
A smarter and better monitored patient in an environment
where drug utilization and compliance increases is a plus for the
industry, said Ric Gross, analyst with HealthLeaders-InterStudy.
"However, the concept may prove to be a zero-sum game
for pharma, where the most effective and least costly drugs gain share
from those that are comparatively less effective or more costly," he
added.
Like P4P initiatives, the medical home payment model
focuses more on outcomes than volume. On the provider side, physicians
gain better monitoring tools, there is an increased focus on efficiency
with physicians prescribing the most effective medications at the
lowest cost and care managers flagging duplicative tests and services.
On the patient side there are more discussions between
the individual and the physician about his or her condition and
treatment, with the expectation that a more informed, educated patient
will be more compliant with treatment, including filling prescriptions
and taking medications as prescribed.
According to the recent New England Health Plan
Analysis, medical home projects seek to maintain costs and improve
health through better treatment compliance, including prescription drug
regimens.
Blue Cross and Blue Shield plans in three states have
rolled out medical home projects in Rhode Island, Illinois and Alabama
with varying numbers of doctors involved in each project.
Address: HealthLeaders-InterStudy, One Vantage Way, B-300, Nashville, TN 37228; (800) 643.7600, www.HL-ISY.com.
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