Louisiana Moves Forward on Medical Home System Implementation

Published September 1, 2008

The head of Louisiana’s Department of Health and Hospitals (DHH) has appointed a Medicaid Reform Committee to help guide the agency in implementing a statewide “medical home” system called for by last year’s Health Care Reform Act (Louisiana Senate Bill 1).

Analysts say the medical home model can provide effective patient-centered care, but its effectiveness depends on the manner of its implementation.

Integrated Care

A medical home system, also known as a Provider Service Network (PSN), integrates several different aspects of care provided to Medicaid beneficiaries. Such a system “incorporates the use of health information technology and quality measures to create a safe, patient-centered, quality-driven, sustainable health care system for Medicaid recipients and low-income uninsured citizens,” according to a DHH release.

The agency says PSNs improve quality of care by creating a patient-focused atmosphere that encourages preventive health care, chronic disease management, and coordination of health care services.

According to the DHH news release, “PSNs also have substantial participating ownership by a hospital and/or provider group(s), creating a financial incentive for providers to invest in the long-term health of beneficiaries.”

Demonstration Project

DHH Secretary Alan Levine appointed the committee’s members–who come from health, academic, and advocacy organizations such as the Louisiana State Medical Society, Louisiana Association of Health Plans, Louisiana Chapter of the American Academy of Pediatrics, and Louisiana Public Health Institute–in late July.

“The Medicaid Reform Committee will counsel the agency as it moves to implement this patient-centered model of care, called Louisiana Health First,” said Levine in a news conference after the announcement.

One of the panel’s major tasks will be to advise DHH as the agency crafts the federal waiver applications required for implementing the Louisiana Health First PSN as a demonstration project.

“Our citizens deserve health care that meets the unique needs of different individuals and different communities. The leaders we have chosen to advise the implementation of Louisiana Health First will help ensure it becomes a model for innovative, sustainable health care,” Levine added.

Nothing Really New

“Like all good ideas, everything depends on the particulars and how it is implemented,” said Greg Scandlen, director of Consumers for Health Care Choices at The Heartland Institute. “If correctly handled, a medical home system can be an effective patient-centered health care option.”

Such systems are already being offered by the private sector, however, Scandlen noted. “I would hope Louisiana would consider recognizing ‘concierge’ physicians [primary care doctors who offer extensive services and focus on individual patients] as medical homes,” he said. “These physicians do everything a ‘medical home’ is supposed to do but without the bureaucracy of some of the medical home models.

“The evidence is growing that medical homes and concierge physicians save more money than they cost, by helping patients better control their chronic conditions and avoid expensive hospital stays,” Scandlen concluded.

Dr Sanjit Bagchi ([email protected]) writes from India.