Using State Health Insurance Exchanges to Drive Better, Most Cost-Effective Care

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    Using State Insurance Exchangesto drive better, more cost effective care

    Patient Centered Primary Care Collaborative

    Updated April 2012

    The Homer Building | 601 13th Street, NW | Suite 430 North | Washington, DC | 20005

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    2 Patient-Centered Primary Care Collaborative

    Executive Summary

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    AcknowledgementsThis publication was developed by the Patient Centered Primary Care Collaborative (PCPCC) with funding support

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    fered to the workgroups leadership:

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    Putting Theory into Practice 3

    Introduction

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    r Delivering high quality health care services through team-based care. Primary care clinicians and other

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    and others) practice team-based care and develop an on-going relationship with the patient in order to manageWKHSDWLHQWpVKHDOWKFDUHQHHGV

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    care team aligns and integrates appropriate resources and services for the patient within a medical neighborhood

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    r Enhanced focus on quality and safety. 3&0+VSURPRWHDFFRXQWDELOLW\IRURXWFRPHVXWLOL]LQJHYLGHQFHEDVHG

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    What is a Patient Centered Medical Home?

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    4 Patient-Centered Primary Care Collaborative

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    practice relies on a well-rounded team of primary

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    providers including mental health specialists and

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    the practices to expand access and incorporate

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    reduction in hospital admissions and decreased

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    Blue Shield brought together a wide range of pro-

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    and patients are grateful for the extra time spent

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    to translate similar cost savings to the Medicaid

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    partnered to help these seven practices develop

    the infrastructure and technology necessary for a

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    staggering especially when coupled with the 17

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    promoting PCMH principles in

    their Health Insurance Exchanges?

    Colorado Arizona

    Rhode Island

    New Jersey

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    Putting Theory into Practice 5

    Ohio

    Minnesota

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    menting a free-market approach in an attempt to reduce

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    information connecting the consumer to the necessary in-

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    UHVSRQVLELOLW\ 8WDKGHYHORSHGD WHFKQRORJLFDOSRUWDO IRUconsumers to access information about health insurance

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    but now several key players within the health care system

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    and the consumers capacity to access reliable and trans-

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    reduces the costs of health insurance with an active pur-

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    proval to offer a wide range of plans and options to both

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    Comparing

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    in Utah and

    Massachusetts

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    family medicine practices in Cincinnati that reaches

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    practices and implementing a model that was bestVXLWHG IRU WKLV SURJUDP WKH ZRUN JURXSGHYLVHG

    a multi-pronged approach to providing tools that

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    forming and maintaining relationships between the

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    6 Patient-Centered Primary Care Collaborative

    What can States do to support

    the creation of Patient

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    Putting Theory into Practice 7

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    stakeholders to enhance the practice and delivery of primary care on a national scale through

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    r Focus on patients.6WDWHVFDQUHTXLUH([FKDQJHVWRLQFOXGHJRYHUQDQFHVWUXFWXUHVWKDWLQFOXGHSDWLHQWVFRQVXPHUVDQGRUWKHLUIDPLOLHV7KLVZLOOHQVXUHWKDWWKHJRDOVRIWKH

    Exchange remain responsive to consumer demands as they reach out to new audiences of

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    Endnotes