Seeking to speak with one voice about preventive care, the seven HMOs in New Hampshire have found common ground in a set of guidelines aimed at primary-care providers and patients.
Medical directors from all seven health plans worked together to develop the guidelines, based on recommendations made by national groups including the federal Centers for Disease Control and Prevention.
A year in the making, the guidelines recommend frequency and timing of everything from routine physicals to diagnostic screenings and immunizations. Though not binding, the harmonized guidelines should cut provider and patient confusion over what constitutes appropriate care.
Calling the cooperative approach unique, Palmer Jones, executive director of the New Hampshire Medical Society, which represents more than 1,800 physicians, said: "Since there is agreement between providers, it has become easier for people to make their (care) decisions."
The Foundation for Healthy Communities brought the players together and coordinated the initiative. The Concord, N.H.-based not-for-profit organization was formed by the New Hampshire Hospital Association nearly 20 years ago to provide research and education to hospitals.
"New Hampshire is now the first state in the country to develop and implement uniform recommendations for preventive care," said Rachel Rowe, the foundation's executive vice president.
The organization is distributing color posters with the guidelines to more than 2,000 primary-care physicians and 30 hospitals in the state, which are to display them prominently in patient waiting areas.
The state Department of Health and Social Services and the health plans are co-funding the project.
Primary-care doctors welcomed the guidelines, which they hope will cut the hassle of differing requirements from the various HMOs in the state.
"This makes preventive care much simpler," said Mark Henschke, M.D., director of Portsmouth-based Appledore Medical Group. "Having a uniform preventive-care guideline will benefit both the physicians and the patients. Physicians can advise their patients better without getting confused about specifics of different plans, while patients can make well-informed, educated decisions."
Laurie Storey-Manseau, spokeswoman for the Dartmouth-Hitchcock Hospital in Lebanon, N.H., also praised the new guidelines, saying they will help advance a preventive-care model of healthcare. "Over time, this new approach to healthcare based on prevention will cut the costs of medical care," she said.
Likewise, Suzanne Boulter, M.D., a pediatrician at Concord (N.H.) Hospital, considered the guidelines "a really positive change" in the preventive-care system of the state. However, she pointed out these guidelines fall somewhat short of the nationally accepted guidelines of the American Medical Association.
For instance, the AMA's Guidelines for Adolescent Preventive Services recommends yearly routine physicals from ages 11 to 21. The New Hampshire guidelines, however, recommend a physical examination every one to two years for adolescents, and every three to five years for those over 18.