Blue Cross and Blue Shield of Kansas City and TransforMED Join with Primary Care Physician Groups in Medical Home Pilot
FOR IMMEDIATE RELEASE
Thursday, November 12, 2009
KANSAS CITY, MO, – Blue Cross and Blue Shield of Kansas City and TransforMED, a wholly owned subsidiary of the American Academy of Family Physicians (AAFP), today introduced a pilot program in which 13 primary care physician groups (family medicine, internal medicine and pediatrics) in the Kansas City area will adopt a new model of health care known as the patient-centered medical home. TransforMED’s practice enhancement facilitators will work directly with doctors and their staff as they implement new technologies and processes to improve patient access and care outcomes, increase patient and physician satisfaction, and reduce errors to lower health care costs. Blue Cross and Blue Shield of Kansas City will provide financial sponsorship for the two-year pilot program.
TransforMED, a national leader in medical home transformation, will work with selected practices to create a collaborative health care setting that builds stronger partnerships between the patient and personal physician. Benefits of this program to patients include:
- Each patient maintains a relationship with a personal physician, who is tasked with providing continuous, comprehensive medical care.
- The personal physician is responsible for providing for the vast majority of the patient’s health care needs or coordinating appropriate care with other health professionals. This includes care at all stages of a patient’s life, acute care, chronic care, preventive services and end-of-life care.
- Care is coordinated by the personal physician across the entire health care system (i.e., sub-specialty care, hospitals, home health agencies, nursing homes). This process is facilitated and is measured through data within electronic medical records containing chronic disease registries and evidence-based care guidelines, reminders for needed services, etc.
“As the patient-centered medical home model of care continues to emerge as a viable means to improve health care and lower costs, it becomes increasingly important for doctors and insurers to work together to help primary care practices adopt this model,” said Terry McGeeney, M.D., MBA, president and CEO of TransforMED. “We commend Blue Cross and Blue Shield of Kansas City for its foresight and commitment to improve the state of primary care in the Kansas City area.”
David Gentile, president and CEO-elect of Blue Cross and Blue Shield of Kansas City said, “The undertaking of this pilot program is a critical initiative for our company. It has the highest level of attention and commitment from both our executive management and our Board. With reform looming for the health care industry, the time is right for a new model of care for patients and their physicians. TransforMED is the leader in their industry, and we look forward to working with them.”
Blue Cross and Blue Shield of Kansas City is sponsoring the two-year pilot and providing financial support in hopes of gaining insight into the costs and benefits of the medical home as they relate to the local primary care community and the company’s provider network. One facet of the pilot will address how insurers can better reimburse participating physicians for attaining desired patient quality, efficiency and patient satisfaction goals, which the physicians will help determine. Currently, physicians are paid based only on the volume of services and are rarely paid for coordinating care and healthy lifestyle counseling. The practices will also be evaluated to better understand the effectiveness of incentives for engaging patients toward healthy lifestyle choices and compliance with their care plan.
Dr. Blake Williamson, vice president and senior medical director of Blue Cross and Blue Shield of Kansas City, stated, “Our overall goals for this pilot include development of a sustainable patient-centered medical home model for the Kansas City primary care community, improved access for patients, and improved quality and efficiency of care.”
TransforMED will provide expert facilitation services over the length of the pilot as each practice adopts the necessary components to be considered a medical home. Selected practices will participate in targeted site visits and semi-annual collaborative meetings. Participating doctors and their staff members will also have access to Delta-Exchange, TransforMED’s professional social networking site that serves as a platform for the practices to collaborate and connect with one another, exchange ideas and share ideas related to medical home transformation.
After an extensive application and selection process, the following practices were chosen to participate in the two-year pilot program. Groups were selected based on a variety of selection criteria, including type of practice, patient population, practice location, ownership status and number of physicians.
- Kansas City Internal Medicine
- Briarcliff Medical Associates
- Spring Hill Family Medicine
- Olathe Medical Systems, Inc. - Olathe Family Practice
- Encompass Medical Group - Hickman Mills
- Clay-Platte Family Medicine Clinic
- Goppert-Trinity Family Care
- Buckles Family Health Care
- Shawnee Mission Physicians Group
- Priority Care Pediatrics
- Jayhawk Primary Care - KU MedWest Family Practice
- Truman Medical Center - Hospital Hill Medical Pavilion
- Child Care Limited
Larry Rues, M.D., a Blue Cross and Blue Shield of Kansas City board member and participating physician in this pilot program, said, “I’m very pleased that Blue Cross and Blue Shield of Kansas City is taking this step to bring the medical home concept to practices in our area. While it will require much work to create this ‘cultural change’ within our practices, I believe the patient-centered medical home model will benefit our patients by elevating the quality of care that will be provided in a more user-friendly environment. I also believe it will increase the number of medical students who will choose to practice primary care, a factor which has been shown to be critical to improving the health of the community while lowering health care costs.”
Practices which applied but were not selected to be part of the pilot program were given the opportunity to become members of TransforMED’s Delta-Exchange networking community and to receive TransforMED’s services at a discounted rate.
About Blue Cross and Blue Shield of Kansas City
Blue Cross and Blue Shield of Kansas City, the largest not-for-profit health insurer in Missouri and the only not-for-profit commercial health insurer in Kansas City, has been part of the Kansas City community since 1938. Blue KC provides health coverage to nearly one million residents in the greater Kansas City area, including Johnson and Wyandotte counties in Kansas and 30 counties in Northwest Missouri. Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association.
For more information on the company, visit its Web site at www.BlueKC.com(www.BlueKC.com). Our mission: to use our role as the area’s leading health insurer to provide affordable access to health care and to improve the health and wellness of our members.
The Leawood, Kan.-based TransforMED LLC is a wholly-owned subsidiary of the American Academy of Family Physicians. Established in 2008, TransforMED provides ongoing consultation and support to physicians looking to transform their practices to a new model of care that is based on the concept of a patient-centered personal medical home. TransforMED is an active member of primary care communities and recognizes and supports the unique value that primary care offers to patients and the health care system. TransforMED shares and supports the idealism and altruism of primary care physicians and the strong commitment to their communities and patients through continuing patient relationships and independent decision making. TransforMED offers practices both products and services, including consultation and advice on implementing the new model. To learn more about TransforMED, visit www.transformed.com(www.transformed.com).
About the American Academy of Family Physicians
Founded in 1947, the AAFP represents 124,900 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.
Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.
To learn more about the specialty of family medicine, the AAFP's positions on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit www.aafp.org/media. For information about health care, health conditions and wellness, please visit the AAFP’s award-winning consumer website, www.familydoctor.org(www.familydoctor.org).