WellStar Health System/Humana Patient-Centered Medical Home

Region Within State: 
Atlanta
Project Category: 
Insurer-Based
PROJECT STATUS
Pilot/Demo Length: 
1.5-2 years

Continue to evaluate the PCMH model of care and the impact on outcomes, quality, and cost for members in commercially insured products. We will be evaluating the performance and success of the project on key clinical, financial, satisfaction, and patient centeredness measures. The evaluation will involve a comparison of quarterly data with baseline data for both the test group and a control group.

CONVENING ENTITY/PROJECT CONTACTS
Convening Organization Name: 
Humana
Primary Contact: 
Chris Corbin
E-mail: 
[email protected]
Phone: 
502/580-3820
Additional Contact
Name: 
Jackie Hayes
Participating Organization Types: 
Humana, Inc.; WellStar Health System.
EXPECTED OR ACTUAL DEMOGRAPHICS OF PARTICIPATING PRACTICES
Number of Practices: 
2
Number of Participating Physicians: 
12
Physicians per practice: 
5-7
Types of Practices: 
Internal Medicine, Family Medicine
Health Plan Lines of Business Included: 
Commercial
Overall Number of Covered Lives: 
850
Technology Characteristics at Start of Pilot: 

Estimated % of practices with practice management systems: >95%
Estimated % of practices with electronic medical record: <5%
Estimated % of practices with registry software: Unknown

PRACTICE TRANSFORMATION SUPPORT (INCLUDING TECHNOLOGY)
Focal areas of transformation: 

Care Coordination
Increased Access
Team Approach to Care

Technology that participating practices have added as a result of their participation: 

EMR and e-Prescribing system as well as a Patient Navigator service

Payment Model: 

Additional care coordination payment

PROJECT EVALUATION
Types of data to be collected : 

Clinical Quality Cost/Efficiency Patient Experience/Satisfaction Provider Experience/Satisfaction Other: Patient Centeredness

Which of the data types are being shared?: 

Clinical, quality, cost and satisfaction data

Are the practices involved in the demonstration participating in any data sharing arrangements? If so please describe.: 

Yes. Health insurance providers involved in the demonstration.

Results to Share: 

Improvement in key diabetes indicators, increase in primary care services while medical expenses overall declined.

Relevant links: 

www.wellstar.org