Blue Cross Blue Shield of Texas setting up 'medical home' program
By: Health Insurance
Submitted: 2010-02-11 09:57:42 | Word Count: 441
Blue Cross Blue Shield of Texas, the state's largest health insurer, said Monday it is implementing a program in five North Texas counties to better emphasize wellness and manage diseases.
The insurer has created a so-called medical home program with two physician groups, Medical Clinic of North Texas and Village Health Partners, which provide care for more than 20,000 members in Dallas, Denton, Tarrant, Collin and Johnson counties.
[ advertisement ]
The term medical home refers to a coordinated system of primary care physicians, specialists and pharmacists sharing a patient's information electronically. Today, the health care system in Texas and the nation is mostly fragmented. Patients with chronic conditions often are treated for each medical symptom rather than managing the underlying disease, such as diabetes.
"The medical home is really the new model of care for the 21st century," said Dr. Christopher Crow, president of Village Health Partners. "It combines the traditional hands-on approach that family medicine has always been known for with the latest technology to ensure patients receive the right care at the right time in the right setting."
Eduardo Sanchez, vice president and chief medical officer of Blue Cross Blue Shield of Texas, said the company's effort to improve health requires a partnership with physicians, which he called the "quarterback guiding patients through the complex health care system."
Blue Cross is not the first health insurer to propose such a program. In August, Cigna HealthCare announced the state's first commercially sponsored medical home program with Medical Clinic of North Texas to serve 10,000 patients. An estimated 10 percent of those patients have chronic conditions and have a higher risk of being admitted to an emergency room, Cigna said.
Although insurers are just embracing the medical home concept, hospitals and physicians long have pushed for medical homes. Children's Medical Center in Dallas invested $2 million to start Physicians for Children as a nonprofit medical-home clinic system in August 2000.
Before the medical home program started, the 75220 ZIP code near Bachman Lake was Children's largest source of minor visits to the hospital's emergency room. But after the medical home clinic opened at Bachman Lake, minor emergency room visits from that ZIP code dropped to sixth among Children's coverage zones.
