UnitedHealth Group, AAFP, AAP, And ACP Join to Advance Primary Care Model
UnitedHealth Group and physician groups to launch “medical home” pilot program to reward primary care doctors who improve patients’ total health
FOR IMMEDIATE RELEASE
Monday, August 06, 2007
American Academy of Family Physicians
(800) 274-2237, Ext. 5224
For the first time, UnitedHealth Group, with the support of the professional societies, will provide enhanced payment to reward primary care doctors whose care is based on this model, and who demonstrate measurable improvements in the overall health of their patients.
The medical home model was initiated by the AAP and developed by leading medical professional societies such as AAFP and ACP. This is the first time that this model will be put into practice with the financial and administrative support of a private health plan.
Each patient will have the choice to select a personal physician, or “medical home,” who knows his or her medical and family history and coordinates their medical care. The physician will be responsible not only for treating a specific ailment or condition, but also for working with the patient to better manage his or her health care needs and arranging care as appropriate with other professionals. The patient-centered medical home model places special emphasis on preventing disease and improving the care of chronic conditions. It emphasizes behavioral health support and patient education as well as the diagnosis and treatment of acute illnesses.
The pilot program will be launched in Florida with approximately six specially-chosen primary care practices that will employ the model. UnitedHealth Group will support the practices participating in the pilot program by integrating its extensive quality improvement and care management into the practices’ infrastructure. This includes sponsoring 24/7 nurse triage and other solutions that extend access to care, identification of and outreach to those who may need clinical interventions; and educational tools and assistance to help patients better manage their conditions. The pilot programs will include customers insured through UnitedHealthcare commercial insurance.
Additionally, this pilot program provides an important opportunity for UnitedHealth Group, the primary care specialty societies, and physicians to learn more about the optimal design of the patient-centered medical home model. UnitedHealth Group and the societies have commissioned an independent research study on the pilot program.
“Care based on the patient-centered medical home can transform how primary care is organized and financed to provide better outcomes to patients, more appropriate payment to physicians, and better value, accountability and transparency to purchasers and consumers,” said Rick Kellerman, M.D., President of the AAFP. “We are optimistic that this pilot program will prove that out.”
Jay E. Berkelhamer, M.D., AAP President said, “The launch of this project is a milestone in advancing the medical home concept. The AAP has long been an advocate for this model of care, which promotes a true partnership between families, their doctor and their care team. A medical home provides a base from which health care services can be coordinated within the community to provide the most effective and efficient care. ”
David C. Dale, M.D., FACP, President of the American College of Physicians, said, “A key element of the patient-centered medical home model is a commitment to improved quality. Primary care practices should exemplify attributes such as dedication to team care, utilization of clinical information systems, coordination of care with other health professionals and support networks, as well as continuous performance assessment and improvement, among others. It is our hope that the full realization of this model will result in increasing numbers of physicians who choose primary care practice and who experience greater professional satisfaction.”
Reed V. Tuckson, M.D., FACP, UnitedHealth Group’s executive vice president and chief of medical affairs said, “UnitedHealth Group and its companies are dedicated to effective, collaborative activities with physician experts and their professional societies that result in enhanced quality and efficiency of care for our customers. We commend the AAFP, the AAP and the ACP, not only for their leadership in developing an innovative care delivery model focused on overall well-being, but also for their commitment to practicing at the highest standards of their profession. We look forward to expanding our relationships with these leading medical professional societies and others, such as the American Osteopathic Association, to expeditiously implement the lessons of this pilot throughout our national network.”
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Founded in 1947, the AAFP represents 110,600 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.
Approximately one in four of all office visits are made to family physicians. That is 240 million office visits each year — nearly 87 million more than the next largest 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.
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 124,000 internal medicine physicians (internists), related subspecialists and medical students. Internists specialize in the prevention, detection and treatment of illness in adults.
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.
UnitedHealth Group (www.unitedhealthgroup.com) is a diversified health and well-being company dedicated to making health care work better. Headquartered in Minneapolis, Minn., UnitedHealth Group offers a broad spectrum of products and services through six operating businesses: UnitedHealthcare, Ovations, AmeriChoice, Uniprise, Specialized Care Services and Ingenix. Through its family of businesses, UnitedHealth Group serves approximately 70 million individuals nationwide.