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Member Research and Reports

Member Research and Reports

George Mason: Enhanced Care Coordination Can Benefit Patients with Multiple Chronic Illnesses

Many studies have reported findings on clinical outcomes, costs and provider viewpoints, however few have evaluated patient experiences with payer-based CareFirst Patient Centered Medical Home (PCMH) programs. In 2001, CareFirst BlueCross BlueShield implemented a PCMH program in its commercial insurance plan. PCMH was created to improve health care quality and help slow rising health care costs, especially for those with multiple chronic illnesses.

Dr. Debora Goetz Goldberg and colleagues led the study. Her research, published in Population Health Management, found that payer-based PCMH models with enhanced care coordination may be beneficial to patients with multiple chronic illness. Patients who completed their care plans had more positive experiences than those who did not, and nurse care coordinators played key roles in the program.

Goldberg explains, “Patients with multiple chronic conditions are at an increased risk for hospitalization, need additional coordination of care, and have high health care costs. Alternative models of care, such as the CareFirst PCMH, are approaches payers are experimenting with to improve the quality of care for these patients.”

The cross-sectional study surveyed 1,308 adults from 2015-2017. These individuals are studied in the context of the CareFirst Patient Centered Medical Home program. Overall, patients responded with positive feedback, however access to care received the lowest rating indicating a need for improvement.

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