Cincinnati medical home pilot set for this fall

Three insurers have agreed to begin paying 11 physician practices in the Cincinnati area will an extra fee for case management under a new patient centered medical home pilot that is set to begin this fall (Source: “Cincy doctors part of primary health pilot program,” Cincinnati Business Courier, July 22, 2009).

Anthem Blue Cross and Blue Shield, Humana Inc. and UnitedHealthcare of Ohio will pay doctors higher fees in exchange for coordinating patients’ care with specialist and focusing on prevention and health maintenance. Together, the practices include 35 physicians who serve about 100,000 patients.

The program is being supported by Greater Cincinnati Aligning Forces for Quality (AF4Q), part of the Health Improvement Collaborative of Greater Cincinnati. The Robert Wood Johnson Foundation is also a partner in the AF4Q program.

“This pilot is one of a very small number across the country aiming to focus practice reimbursement on prevention and maintenance of health rather than respond to acute illness,” said Craig Brammer, senior research associate at the University of Cincinnati and director of Cincinnati AF4Q.

The eleven practices were selected from among 25 applicants through a competitive process based upon:

• Their readiness to successfully complete the transformation process
• A balance of geographic and specialty distribution
• A spectrum of practice sizes
• Rural and urban representation
• A balance between  individual practices and those affiliated with health systems