Blog: Blues CMO says there's 'no question' medical-home model works

Without hesitation, Dr. Allan Korn, the Blue Cross and Blue Shield Association's chief medical officer and senior vice president for clinical affairs, declared that the patient-centered medical home has the potential to transform the U.S. healthcare system.

"The things you want going up are going up, and the things you want going down are going down," said Korn in an interview following his appearance Monday on a panel assessing the state of the healthcare industry presented in San Antonio at the MGMA-ACMPE's annual conference. "There's no question that the medical home is working, and that's what's gratifying to me."

While speaking on the panel, Korn said he thinks steps could be taken to improve the patient-centeredness of the medical-home practice model. Still, he said later, medical homes—which use information technology to coordinate care and track the treatment of patients who have chronic diseases—have led to double-digit declines in patients' exposure to radiation from diagnostic tests, in "ambulatory-sensitive" hospital admissions, and in unnecessary and costly healthcare episodes.

They have also boosted physician satisfaction.

"When you permit a physician to perform at his or her highest level, to do what they want to do, these are things that happen," Korn said, adding that one important thing the Blues' medica- home programs have done is remove the "mother may I's” from the practice of medicine. "We're having doctors tell us 'I'm looking forward to going to the office again.' "

He added that, with some 5.3 million members covered by Blues medical homes, "we're not piloting anymore."

Korn also said that Blues members are still free to see a specialist. But because they get advice from a primary-care physician first, they can see the specialist they need without wasting time or undergoing unnecessary tests.

"There's no barrier to specialty care," Korn said, explaining that the goal is to reverse the fragmentation of healthcare. "It's not a gatekeeper role; that's not the idea."

He also noted that the medical-home model is not a way of boosting the income of primary-care doctors at specialists' expense.

"It's not their contribution to care we want to eliminate," Korn said. Rather, the goal is to eliminate the "downstream costs" of avoidable tests and treatments.



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