Health Care

Health plan opens door to home-based primary care

September 10, 2013
| By Pete Daly |
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Priority Health expands Medicare services
Nearly 50 percent of seniors live with two or more chronic diseases, the Centers for Disease Control and Prevention reported in 2010. ©iStockphoto.com

A Grand Rapids-based health plan has launched a statewide home-based primary care service to deliver health care in the homes of patients living with advanced chronic illness.

Priority Health Home-Based Primary Care provides each patient with a primary care team that includes a doctor, nurse practitioner, registered nurse case manager and social worker.

Through the program, patients receive important routine and preventive care and direct access to care.

Priority Health said it is “scaling the model” to work with hospitals and local health care providers throughout Michigan.

It is enrolling members in Michigan’s major metro areas.

“Advanced chronically ill patients struggle with access in today’s health care delivery system, which requires them to travel to a physician or facility to receive routine medical services,” said Dr. Jay LaBine, medical director for Priority Health. “With Home-Based Primary Care, we’ve leveraged our expertise to take the concept of a doctor’s office and broaden its reach to literally meet patients who need support most, where they need it most — in their home.”

Home-based pilot program

Priority Health launched the program last year as a pilot with Spectrum Health Medical Group for 90 patients.

Since the launch, the patients have seen significant improvements in their health. Their emergency room and hospital inpatient visits for treatment have decreased by 47 percent.

Both organizations credit being able to quickly launch the pilot as a benefit of being part of the Spectrum Health integrated health system.

“We are committed to improving the quality of health care for Michigan residents,” said Dr. Kenneth J. Fawcett, Jr., interim president of the Spectrum Health Medical Group. “By working as a system, we can successfully leverage efficiencies and change the model of care for those with complex chronic conditions, ultimately improving their quality of life.”

Chronic disease rates rise

The number of patients who are struggling with multiple chronic illnesses — like diabetes, cancer and heart disease — is growing, according to Priority Health.

Nearly 50 percent of seniors live with two or more chronic diseases, the Centers for Disease Control and Prevention reported in 2010. This is up from 20 percent in 2003.

Seventy-one percent of each Medicare dollar is spent on patients with both chronic conditions and physical limitations, the Centers for Medicare and Medicaid Services reports.

“We’re convinced that by investing early in the health of these patients we’ll avoid costly services later on,” added LaBine. “And this theory is already playing out to be true as we see patients, enrolled in this program, having fewer visits to the hospital and emergency room.”

Priority Health, which is owned by Spectrum Health, is a nonprofit health plan.

Home-Based Primary Care Patients must be referred by their primary care physician and qualify for the program.

Services

Once approved, each patient receives several services.

- A complete health assessment

- Around-the-clock medical support

- A patient-specific plan of care that evolves as needs change

- A nurse care manager to monitor patient care

- Occupational, physical, respiratory and speech therapy

- Education about medications, telemonitoring procedures and health emergency preparedness

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