S.C. Medical Home Pilot For Diabetes Enrolls 1,110

Main Category: Diabetes
Also Included In: Clinical Trials / Drug Trials
Article Date: 28 Jul 2009 - 0:00 PDT

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A patient centered medical home pilot project that could become a model for South Carolina has completed its first quarter with 1,110 patients enrolled. It is also attracting the attention of S.C. physicians not involved in the program, and S.C. businesses are interested in it as a means to managing their health care costs.

The project, a year-long collaboration started in April, is focusing on diabetic patients who are members of BlueCross BlueShield of South Carolina, BlueChoice HealthPlan of South Carolina, and the State Health Plan and who are patients of Palmetto Primary Care Physicians in the Charleston, S.C., area.

Patient centered medical homes integrate quality improvement, coordinated care management and patient educational services into primary care practices. The concept places the primary care doctor in charge of a team that can include social workers, pharmacists, wellness coordinators, nurses, disease managers, certified diabetic educators, dieticians and pharmacists all working together to proactively reach out and develop an individual treatment plan for patients.

In the first three months, case managers hired for the project have contacted 60 percent of the eligible patients to explain the concept, to gather baseline health data, and to encourage them to use an online portal that contains tools that help manage their disease and enable them to have "e-visits" with a physician.

The case managers aim to reduce gaps in care, such as missed appointments with specialists, and lifestyle issues such as medication adherence. They also perform outreach, such as registering patients for diabetic education, scheduling appointments with specialists, providing discount vouchers for medications, offering discounted memberships to local gyms, and monitoring quality processes and outcomes measures to help increase patient compliance.

"Our case managers have been calling patients who are eligible for the pilot project, and the patients absolutely love it. We've been able to provide patients with additional resources and education. Furthermore, we are able to encourage patients to make diet and exercise changes as well as schedule appointments for their concerns before the problem gets worse," said Jennifer O'Donnell, director of quality improvement for Palmetto Primary Care Physicians.

There is no copayment or extra charge to the patients for participation in the pilot.

Dr. Laura Long, BlueCross' vice president of clinical quality and health management, and Dr. Kirt Caton from Palmetto Primary Care Physicians addressed the South Carolina Academy of Family Physicians at a meeting in Litchfield Beach, S.C., on Saturday. "As the debate continues nationally about health care reform, we're already on the cutting edge with this new look at delivering health care," Dr. Long said. "We've been invited to address a number of meetings of business and medical societies."

"The goal is to reduce the disconnects in health care, improve quality of life for the patient, create tighter relationships and better communications, and add for the first time a focus on measurement of quality and continuous improvement of clinical outcomes. We're pleased to work with BlueCross, BlueChoice HealthPlan and the State Health Plan and their diabetic members in this pilot and believe this could be a state model," said David L. Castellone, M.D, president of the Palmetto Primary Care Physicians board of directors.

Headquartered in North Charleston, S.C., Palmetto Primary Care Physicians has 57 providers and 350 employees in 19 clinics located in Charleston, Dorchester and Berkeley counties. Palmetto Primary Care Physicians has offices in: Summerville, North Charleston, Goose Creek, Daniel Island, Moncks Corner, Bonneau, Hanahan and St. Stephen.

Headquartered in Columbia, S.C., BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina are independent licensees of the Blue Cross and Blue Shield Association. The only South Carolina-owned and operated health insurance carrier, BlueCross BlueShield of South Carolina and its family of companies include more than 20 subsidiaries involved in health insurance services, U.S. DoD health plan and Medicare contracts, and other insurance and employee benefits services.

Source: BlueCross BlueShield of South Carolina

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