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Patient-Centered Medical Home. PROTECT PROMOTE IMPROVE. Patient Centered Medical Homes: Keeping People Healthy and Controlling Health Care costs. Ted Wymyslo, MD Director Ohio Department of Health ProMedica Oct. 31, 2011.

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Patient centered medical home

Patient-Centered Medical Home


Patient centered medical home

PROTECT PROMOTE IMPROVE


Patient centered medical homes keeping people healthy and controlling health care costs

Patient Centered Medical Homes:Keeping People Healthy and Controlling Health Care costs

Ted Wymyslo, MD

Director

Ohio Department of Health

ProMedica Oct. 31, 2011


Ohio s health system performance

Ohio’s Health System Performance

Health Outcomes – 42nd overall1

  • 42nd in preventing infant mortality (only 8 states have higher mortality)

  • 37th in preventing childhood obesity

  • 44th in breast cancer deaths and 38th in colorectal cancer deaths

    Prevention, Primary Care, and Care Coordination1

  • 37th in preventing avoidable deaths before age 75

  • 44th in avoiding Medicare hospital admissions for preventable conditions

  • 40th in avoiding Medicare hospital readmissions

    Affordability of Health Services2

  • 37th most affordable (Ohio spends more per person than all but 13 states)

  • 38thmost affordable for hospital care and 45thfor nursing homes

  • 44thmost affordable Medicaid for seniors

Sources: (1) Commonwealth Fund 2009 State Scorecard on Health System Performance

(2) Kaiser Family Foundation State Health Facts (updated March 2011)


Half put off care due to cost

Half Put Off Care Due to Cost

Percent who say they or another family member living in their household, have done each of the following in the past 12 months because of the cost:

Skipped dental care or checkups

Relied on home remedies or over-the-counter drugs instead of going to see a doctor

Put off or postponed getting health care needed

Not filled a prescription for a medicine

Skipped a recommended medical test or treatment

Cut pills in half or skipped doses of medicine

Had problems getting mental health care

‘Yes’ to any of the above

Source: Kaiser Family Foundation Health Tracking Poll (conducted March 8-13, 2011)


Medical hot spot emergency department utilization ohio vs us

Medical Hot Spot:Emergency Department Utilization: Ohio vs. US

Hospital Emergency Room Visits per 1,000 Population

29%

Source: American Hospital Association Annual Survey (March 2010) and population data from Annual Population Estimates, US Census Bureau: http://www.census.gov/popest/states/NST-ann-est.html.


Patient centered medical home

SOURCE: Adapted from Melanie Bella, State Innovative Programs for Dual Eligibles, NASMD (November 2009)


Patient centered medical homes

Patient-Centered Medical Homes

  • Primary Healthcare Provider

  • Whole Person Orientation

  • Care is Coordinated and/or Integrated

  • Quality and Safety are Hallmarks

  • Enhanced Access

  • Payment for Value


Patient centered medical home

PCMH

Insurers

Employers

Patients

Providers


Blended reimbursement

Blended Reimbursement


Ohio patient centered primary care collaborative

Ohio Patient-Centered Primary Care Collaborative

  • Facilitatedbythe Ohio Department of HealthResponsibilities:

    • Coordinates communication among existing Ohio PCMH practices

    • Facilitates statewide learning in collaborative PCMH practices in Ohio

    • Facilitates new PCMH practice startup in Ohio

    • Shapes policy in Ohio for statewide PCMH adoption


The end goal health care consumers that are involved in their care

The End Goal: Health Care Consumers that are Involved in Their Care

  • Better Care Coordination: Providers interact with their patients on a continual basis

  • Electronic Connectivity: Providers communicate with each other and their patients about their care

  • Patient Navigators: More care happens outside the provider’s office through the patient navigator

  • Payment reform: providers are incented and reimbursed for keeping their patients healthy


Contact information

Contact Information

Ted Wymyslo, M.D.

Director, Ohio Department of Health

(614) 466-2253

[email protected]


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