Right Incentives Drive Success in Medical Home Study

July 21, 2015 01:41 pm Michael Laff – A recent study that examined a medical home initiative in northeastern Pennsylvania revealed that with the appropriate blend of financial incentives and clear targets for success, the model can reduce the number of costly procedures and improve care delivery.

The three-year study, "Effects of a Medical Home and Shared Savings Intervention on Quality and Utilization of Care,"(archinte.jamanetwork.com) was published online in JAMA Internal Medicine in June and revealed positive results about the model's potential to transform care delivery.

The study began in 2009 and included 27 small primary care practice sites and two commercial insurers. Practices in the Pennsylvania Chronic Care Initiative were small, typically composed of three physicians each, and were required to attain recognition as medical homes from the National Committee for Quality Assurance. The insurers were the dominant insurance providers in the market.

Practices that participated in the initiative received a $1.50 monthly payment per patient to be used for care manager salaries and another $1.50 monthly payment per patient for other practice transformation costs. In addition, practices that had lower total annual spending on patients than anticipated and that met specified performance measures in 14 areas earned bonus payments ranging from 40 percent to 50 percent of savings.

Significant flexibility allowed practices to determine their own method for calculating savings. There was no financial penalty for exceeding projected annual spending.