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Home / News & IndustryManaged Care Insight and Analysis
Updated: November 23, 2010
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,

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

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