Highmark's Patient-Centered Medical Home program reports success in year two

Pittsburgh-based Highmark's Patient-Centered Medical Home program proves successful in its second year with lower percentages of readmission rates, emergency room visits, prescriptions, and inpatient care and inpatient surgeries, according to a company statement.

More than one million of Highmark's 5.2 million members now receive improved coordinated care as part of the PCMH program, at over 930 medical practices in Pennsylvania, Delaware and West Virginia, according to the statement. The program holds physicians accountable for providing patients with treatment options, decision making assistance, improved use of EHRs and better patient education.

Highmark gauged their success on data collected from 152,000 second-year PCMH members in central and western Pennsylvania. They found the following lower than comparable market rates:

• Readmission rates for commercial PCMH patients 1 percent lower than the market, 2 percent for Medicare Advantage patients

• Emergency room visits 16 percent lower for adults, 14 percent for Medicare Advantage patients and 13 percent for children

• Adult prescription drug use 7 percent lower

• Inpatient surgeries 12 percent lower for adults, nine percent for Medicare patients

• Inpatient medical utilization 25 percent lower for Medicare patients

"We continue to be very encouraged by the results from our Patient-Centered Medical Home program," said Paul Kaplan, MD, Highmark senior vice president of provider strategy and integration. "We believe the program is working well."

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