Prevention: primary care’s new approach

Associated Press

INDIANAPOLIS

A budding model for primary care that encourages the family doctor to act as a health coach who focuses as much on preventing illness as on treating it has shown promising results and saved insurers millions of dollars.

Growth in emergency-room visits and hospital admissions slowed and prescription-drug costs have been tamed with this approach, known as patient-centered medical homes, or just medical homes.

The current health-care system pays doctors to see patients and largely attend to their immediate needs. Patients may get treatment, advice, a prescription and a follow-up appointment.

Patient-centered medical homes focus on keeping patients healthy, which saves money by reducing hospital visits, especially for chronic conditions such as diabetes.

WellPoint Inc., UnitedHealth Group Inc., and other insurers have pilot projects around the country testing this concept. The departments of Defense and Veterans Affairs plan to use medical homes, and more than a million Medicare recipients are involved in another test.

An estimated 40,000 primary-care doctors work in practices set up as patient-centered medical homes, according to the Patient Centered Primary Care Collaborative. That’s about 13 percent of all doctors and pediatricians.

Michigan’s largest insurer says it saved $65 million to $70 million last year through its medical-homes program. But the idea requires big changes to traditional primary care, and experts say that may slow its growth.

Patients say they like the greater involvement of their doctors.

Under the medical-home approach, doctors use electronic records to track patients between visits and act as the central point of communication between specialists, nutritionists and others.