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State's largest Health Insurance Co. sets foundation in LA

State's largest Health Insurance Co. sets foundation in LA
Monday, December 5, 2011 - 12:01pm

As the nation prepares for landmark changes in the U.S. healthcare system, Blue Cross and Blue Shield of Louisiana will host an educational summit Tuesday, Dec. 6, at Pennington Biomedical Research Center in Baton Rouge to discuss an innovative healthcare delivery model that is sweeping the country—the patient-centered medical home.

Blue Cross President and CEO Mike Reitz and Chief Medical Officer Dr. Kenneth Phenow will join national healthcare experts to outline this innovative concept of healthcare delivery that aims to strengthen coordination and accountability in managing patient healthcare needs. Executives from IBM, one of the many large employers nationwide looking for ways to control employee healthcare costs, will attend the summit. The event’s faculty includes Dr. Paul Grundy, who is president of the Patient-Centered Primary Care Collaborative and IBM’s director of healthcare transformation.

The medical home concept is not a place or building, but a better way to coordinate the current fragmented, uncoordinated healthcare delivery system. It is a model of care that encourages and strengthens the doctor-patient relationship by replacing episodic and reactive disease-focused care with organized and proactive care, focused on preventing disease and preserving health.

According to a review of available literature done in 2009 and 2010 by Grundy and Dr. Kevin Grumbach, chairman of the Department of Family/Community Medicine at the University of California, San Francisco, patient-centered medical homes have led to lower medical costs and shorter hospital stays.

According to the review, in South Carolina, patients in the patient-centered medical home started by Blue Cross and Blue Shield had medical and pharmacy costs that were 6.5% lower than the control group. Patients in a similar Blue Cross program in North Dakota saw hospital admissions drop by 6% and emergency room visits fall by 24%. During that same period, in the control group, hospital admissions were up by 45% and emergency room visits rose by 3%. For a link to other findings about patient-centered medical homes, visit

“The healthcare industry is facing unprecedented change. Blue Cross and Blue Shield of Louisiana has answered the call for new and innovative delivery models by embracing the concept of the patient-centered medical home,” said Reitz.

“Accountable, collaborative, coordinated care delivered through the patient-centered medical home will transform healthcare delivery,” said Phenow. “As an industry, we have evolved as far as we can using costly, fragmented, fee-for-service payment. As we transform, pay-for-value models like those embodied by the PCMH approach will help us achieve better health and better care at a better cost.”

Grundy said, “Comprehensive, coordinated and integrated primary care works. The aim is better care, fewer hospitalizations and keeping patients healthier by taking the needed time for each individual patient, building a relationship and helping them manage their health for the long haul.”

The summit will include presentations by leading healthcare industry experts during a general session and working lunch held from 11 a.m. to 4:30 p.m. An evening session for healthcare providers will begin with a cocktail hour from 5 to 6 p.m., with the presentations and a working dinner being held from 6 to 9 p.m.

To view the summit program and register for the free event, click here. The summit will be available for free viewing online. To register, click here. To watch, visit this website.

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