Updated Tuesday, March 3, 2009.
Cleveland’s MetroHealth System on Monday officially launched its pilot of the medical homes concept: MetroHealth Partners in Care.
The project aims at improving patient health, clearing away barriers to medical care — and lowering the cost of that care — through a coordinated team of medical professionals who are centered around patient needs, MetroHealth said.
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The pilot also could help MetroHealth deal with the rising amount of uncompensated care it provides as the Cuyahoga County-owned hospital. “I think it will make the challenges that we have a lot more manageable,” the system’s interim chief executive, Mark Moran, said last week.
“We’ve got all the ingredients — the full continuum of care, the disease management programs, great primary care resources that we manage in a little bit different way that’s going to have much better outcomes for the patients,” Moran said after the system’s monthly trustee meeting.
Starting at its Lee-Harvard Health Center on the city’s East side, a team of doctors, nurses, social workers, nutritionists, mental health professionals and financial counselors will create a “medical home” for qualified patients who lack health insurance. The team is designed to care for up to 4,000 patients, MetroHealth said.
The team will be led by doctors but patient care will be coordinated by nurses, said Eileen Korey, the system’s vice president of communications.
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The “patient-centered medical home” model has emerged in the last several years to answer the needs for rising health care costs and falling quality of care. The model puts care coordination in the hands of medical professionals, not health insurance case managers, according to the American College of Physicians, which is trying to pioneer the homes among its members.
The model pays doctors for coordinating care, say, through a monthly care coordination payment. It also gives doctors financial incentives to use technology such as electronic health records and innovative practices like telephone consultations rather than office visits to lower health care costs and improve quality of care.
In addition to paying doctors for office visits — an element of the existing “pay-for-service” model — the medical home model also pays doctors for meeting quality and efficiency goals.
Since its unofficial start last week, MetroHealth Partners in Care has enrolled about 20 patients for the pilot, Korey said. All patients will take health-risk assessments to identify chronic conditions, such as high blood pressure, that must be monitored and controlled to achieve maximum health for patients.
Enrollees also will be required to sign a commitment “to keep scheduled appointments, respect the members of the Care Team, and follow the care plan personalized for me” on the backs of their membership cards, MetroHealth said.
Patients whose incomes fall below 200 percent above of the national poverty level will be charged a $5 fee at the time of service. These fees will be capped at $15 for each 30-day period, MetroHealth said.
Uninsured patients whose income falls below 400 percent of the poverty level will be charged discounted rates.
MetroHealth hopes to demonstrate that providing medical care through partnerships with patients produces long-term health benefits for patients and reduces the cost of medical care in Cuyahoga County.
