Improving patient care and curbing rising health care costs are among the goals of an effort Blue Cross and Blue Shield of Nebraska is launching on Friday.
The six-month trial program involves primary care doctors, clinics and patients in nine Nebraska cities including Omaha, Lincoln and Kearney.
The program is intended to test the effectiveness of the “medical home” model. Under that model, a primary care doctor is established as the main provider and coordinator of a patient's health care needs, said Dr. Bill Minier, vice president and chief medical officer for Blue Cross.
The primary care doctor not only will provide routine exams, but also will coordinate the care that patients receive from outside specialists, he said.
The goal is for the primary care doctor to ensure that the patient is getting necessary care and that needed tests and follow-up exams are not falling through the cracks.
The medical home model is an idea that has received attention during the health care reform debate as a way to strengthen doctor-patient relationships.
The primary care doctors will use an Internet program that creates medical checklists that are tailored for each patient. The checklist will help the primary care doctor know, for example, if it's time for a certain immunization or preventive screen such as a mammogram.
The pilot effort will focus on 1,200 diabetic patients but providers can use the Internet program for all their patients.
After the program ends, it will be evaluated based on a number of factors, including days spent in the hospital, emergency room visits and adherence to medications.
Minier said the medical home approach can curb costs by keeping patients out of the hospital and out of the emergency room.
Medical providers in the pilot program will be eligible to receive incentive payments totalling $3,000 to $5,000 from Blue Cross based on how well their patients' diabetes is managed, Minier said.
Other communities involved are Auburn, Geneva, Grand Island, Lexington, Nebraska City and West Point.
The Blue Cross medical home program is endorsed by such groups as the Nebraska Academy of Family Physicians and the Nebraska Medical Association.
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