CareFirst finds savings in 'patient-centered medical home' model

A program launched in 2011 by the state's largest health insurer to better coordinate patient care has slowed its overall pace of spending, avoiding millions in costs for the health system and the insured, CareFirst Blue Cross BlueShield reported Thursday.

The idea behind the so-called patient-centered medical home model is to keep people, particularly those with chronic medical conditions, healthy and not in need of expensive interventions. CareFirst was among the early adopters, though many insurers and health systems have launched programs in Maryland and around the country.

Federal authorities also have encouraged such efforts under the Affordable Care Act, and Maryland has adopted a unique payment system that also pushes hospitals to keep their patients well as a means of curbing spending. The state also operates its own medical home pilot program that ends this year.

"The medical cost trends we are seeing are remarkable and energizing," said CareFirst President and CEO Chet Burrell, who held a conference call with reporters Thursday. "Even with slowing national medical cost trends in the last few years, to see sustained overall increases as low as we are now seeing is dramatic."

Burrell didn't attribute the slowing expenditures solely to the program; nationally spending growth has slowed. But he said before the program began rates of spending increased an average of 7.5 percent a year. By 2014, the rate of increase was 3.5 percent overall and 2 percent for participants in the program.

There are about 1 million people covered by the program at CareFirst, which services Maryland, Washington and Northern Virginia. About 80 percent of primary care providers in the insurers' network participate.

Health care costs for those participating in CareFirst's program were $345 million less than projected in 2014, the insurer said. The costs were more than $600 million less than expected since 2011.

Officials at the Patient-Centered Primary Care Collaborative, an advocacy group, said they were excited by CareFirst results and said other programs around the country had similar outcomes. But they said challenges remain in evaluating the medical home model because there are no uniform evaluation measures.