UnitedHealth Group Pilot Project To Test Patient-Centered Medical Home

For the first time, a major insurance plan is putting money on the table to test whether health care delivered in a patient-centered medical home really does improve the delivery of care, improve overall patient health and reduce total health care spending.

UnitedHealth Group is working with the AAFP, the American Academy of Pediatrics and the American College of Physicians to undertake the pilot project, which will launch in Florida with a small number of primary care practices yet to be chosen.

"This is about physician payment reform and testing the patient-centered medical home model in the marketplace," said AAFP President Rick Kellerman, M.D., of Wichita, Kan.

For some time, the Academy has urged payers and employers to implement pilot programs that would experiment with new payment strategies to reflect the value of primary care, said Kellerman.

"We've been aggressively reaching out to health plans, and UnitedHealth Group is the first payer to step forward and put a program in play," he said, adding that the Academy is optimistic that the pilot will show that the patient-centered medical home is a "win-win" for everyone involved.

"We should see improved patient outcomes and overall better value for patients, employers and health plans," Kellerman said. All of those components should make a compelling case for fairer payment for family physicians, he noted.

Reed Tuckson, M.D., UnitedHealth Group EVP and chief of medical affairs, said in an AAFP press release that UnitedHealth Group was looking for "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," said Tuckson.

After the pilot project is up and running, UnitedHealth Group will support the participating primary care practices by helping them incorporate quality improvement and care management systems to increase access.

UnitedHealth Group will pay participating physician practices a monthly care-management fee based on projected savings for all patients that select a medical home. In addition, the company will share any excess savings that accrue from the pilot program with the physician practices and -- by way of premium reductions -- with employers.

UnitedHealth Group has commissioned an independent research study designed to evaluate and assess the results of the pilot's experimentation with the patient-centered medical home model of care. Plans call for those study results to be published in a peer-reviewed journal in the future.