Patient Centered Medical Home: Community Medical Providers’ Success

Looking for ways to improve the health of beneficiaries and address the escalating costs of care, the self-insured Fresno Unified School District/Joint Health Management Board (JHMB) decided in late 2010 to join the California Academy of Family Physicians (CAFP) in supporting a local Patient Centered Medical Home (PCMH) initiative. In July 2012, after 18 months of preparation and training, a primary care medical group – Community Medical Providers (CMP) – launched the initiative. One year later, at the end of June 2013, CMP had saved the district nearly $1 million in total claims. 

The project, a collaboration of CMP, CAFP and the School District, covered approximately 2,500 patients comprising 10 percent of the District’s 25,000 beneficiaries. 

Goals included improving the quality of care in specific disease areas such as diabetes, cardiovascular disease and behavioral health; improving prevention and medication adherence; and reducing costs associated with emergency room visits, hospital admissions and prescription drugs. The primary care practices in this project succeeded in all of these areas.