Highmark launched a pilot PCMH in 2011 that included 12 physician practices and covered about 45,000 members. It reduced costs by nearly 2 percent while the costs for the remainder of Highmark’s members grew.
The pilot program also resulted in a 9 percent reduction for inpatient acute admissions, 13 percent reduction in 30-day readmission rates and a 14 percent reduction in 7-day readmission rates.
The expanded model will include more than 100 physician practices and covers approximately 171,000 Highmark members. During the next three years, Highmark hopes to have about 75 percent of members in some kind of pay-for-value arrangement.
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