The PCMH is a reality in 16 primary care practices in Colorado that have participated in one of the nation’s first Multi-Payer, Multi-State Patient-Centered Medical Home Pilots, along with stakeholders at both local and national levels. Convened by HealthTeamWorks, the project began in 2008 and runs through 2012.

1. ®
Patient-Centered Medical Home Pilot Generating
Pivotal Changes in Healthcare Delivery
By Marjie Harbrecht, MD of care. That’s the patient-centered • Practice redesign using a team-
Chief Executive Officer medical home (PCMH). based approach, including care
HealthTeamWorks
coordinators/care managers; and
The PCMH is a reality in 16 pri-
mary care practices in Colorado • Technology, such as electron-
that have participated in one of the ic health records with ability
nation’s first Multi-Payer, Multi- to facilitate information ex-
State Patient-Centered Medical change, and report data.
Home Pilots, along with stake-
holders at both local and national Colorado’s PCMH pilot among
levels. Convened by HealthTeam- most complex
Works, the project began in 2008
and runs through 2012. It is one The Colorado PCMH pilot tests
of many national endeavors initi- the model in 16 small indepen-
ated to demonstrate that resources dent family medicine and inter-
invested in primary care result in nal medicine practices along the
better care, reduced cost trends and Colorado Front Range. Payment
an improved experience for the pa- for the pilot began in May 2009,
tient and the healthcare team. once practices met requirements
to achieve Medical Home recogni-
Imagine a medical practice eas- The medical home emphasizes tion from the National Committee
ily accessible to patients via tele- whole-person orientation with co- for Quality Assurance (NCQA).
phone or online, where your care is ordinated care across all elements The participating health plans —
thorough, unhurried and personal. of the healthcare system. The Anthem-Wellpoint, United Health-
Your records are maintained elec- PCMH features: care, Humana, Aetna, CIGNA,
tronically, making them instantly Colorado Medicaid and CoverCol-
available to clinic providers and • Enhanced access, making it orado — pay practices for 20,000
referral physicians. Coordination easier for patients to contact covered patients, although prac-
with specialists and community their personal healthcare team; tices provide services to more than
healthcare resources occurs swiftly 100,000 patients.
and smoothly. You develop a care • Emphasis on prevention and
plan with your doctor and work to- proactive management of The Colorado effort stands apart
gether with your healthcare team chronic conditions, improving because of its complexity — seven
to achieve your goals. Healthcare clinical quality and safety; public/private payers are involved
payers give incentives to the prac- — and the level of collaboration
tice for the value of the care it de- • Engaging patients in their care among those payers. The health
livers, rather than for the volume to attain optimum health; plans joined the program volun-
-1-

2. tarily. They compensate providers The Commonwealth Fund and the The PCMH is based on years of
using a blended payment model — Colorado Trust fund the pilot. research that supports the need to
fee-for-service, per-member-per- bolster and reorganize the deliv-
month for care coordination, and a Results show model is working ery of primary care and how it’s
pay-for-performance bonus. paid for. But medical homes alone
May marks the two-year anni- won’t be sufficient without support
HealthTeamWorks serves as the versary of the PCMH pilot in from the medical neighborhood.
convening organization for the Colorado, and early results are Every segment of the healthcare
PCMH Pilot practices in Colorado. promising. Practices have made system stands to benefit from this
It also provides in-office coaching, tremendous strides in building in- coordinated patient-centric ap-
innovative technology support and frastructure, including on-site care proach: patients, providers, em-
learning collaboratives to devel- management services. Trends are ployers and payers.
op PCMH processes and culture showing improvement on qual-
change, and bring participating ity measures, coordination of care Higher goals for pilot’s next two
practices together to share expe- and satisfaction. For example, the years
riences. The pilot is evaluated by graph depicts the pilot’s success in
Meredith Rosenthal, PhD, from the improving measures for diabetic During the pilot’s next phase,
Harvard School of Public Health, patients from June 2009 to Decem- HealthTeamWorks’ will continue
to determine the effect on quality, ber 2010. Practices also target car- to:
cost trends and satisfaction for pa- diovascular disease, depression,
tients and their healthcare teams. and prevention. • Provide on-site coaching to im-
-2-

3. prove clinical quality, coordina- pilot practices have achieved in levels. Harbrecht serves on several
tion of care and satisfaction; two years, and we know they will statewide boards and committees,
accomplish even more going for- including the Colorado Regional
• Connect practices for peer-to- ward. They are transforming the Health Information Organization
peer learning; paradigm of healthcare delivery and the Center for Improving Val-
in a way that is patient-centered, ue in Healthcare. She is a member
• Promote information sharing effective and affordable. The pa- of the national Patient-Centered
between the health plans and tient-centered medical home will Primary Care Collaborative Pay-
physician offices; provide a foundation for health- ment Reform Taskforce and Cen-
care transformation in this country ter for Accountable Care, and
• Focus on reducing healthcare as we move toward more integrat- the NCQA PPC-PCMH Advisory
costs by decreasing emergency ed community care. Committee that helped develop
room use, hospital admissions/ the 2011 PCMH standards. Har-
readmissions, and pharmaceu- Marjie Harbrecht, MD, is a board- brecht lectures nationally about
tical costs; and certified family physician and CEO health system change, quality im-
of HealthTeamWorks, which she provement and patient safety. She
• Expand connections with has led since 1999. HealthTeam- is an assistant clinical professor at
“medical neighborhoods,” in- Works is a nonprofit collaborative the University of Colorado Health
cluding mental health, special- that implements and evaluates evi- Sciences Center.
ists and hospitals. dence-based care through redesign
and culture change at the practice,
We are very proud of what our community and healthcare system
Reprinted with permission from the Colorado Healthcare News. To learn more about the Colorado Health-
care News visit colhcnews.com.
-3-