Highmark expands medical home idea

Health insurer Highmark Inc. on Wednesday announced that it will greatly expand its patient-centered medical home initiative to 1,050 primary care doctors in more than 100 physician practices in Pennsylvania and West Virginia.

The initiative continues a pilot program that began in June 2011, involving around 45,000 members. The expansion will bring the new approach to health care to about 171,000 members in Pennsylvania and West Virginia.

“We demonstrated a number of positive outcomes from the pilot practices, including lowering per-member-per-month overall cost,” Michael Fiaschetti, president of health markets at Highmark, said in a prepared statement. The health insurer plans to have 75 percent of its membership in some kind of pay-for-value arrangement by 2015.

Among the pilot’s accomplishments:

  • Inpatient acute admissions dropped by an average by 9 percent
  • Seven-day readmission rates dropped an average of 14 percent
  • Five percent decrease in total per-member-per-month costs for members with heart disease; 3.5 percent decrease for people with diabetes.

Medical homes use a comprehensive approach to patient care, which reduces health care costs while maintaining or improving members’ health. Highmark affiliate Premier Medical Associates, a multispecialty medical practice based in Monroeville, was among the early pioneers of the concept in the Pittsburgh area.