July/August 2008 Annals of Family Medicine... ( Innovative North Carolina Program I...)

July/August 2008 Annals of Family Medicine tip sheet

Date:7/14/2008

Innovative North Carolina Program Improves Patient Care and Saves an Estimated $160 Million in Medicaid Costs Annually

Community physicians in North Carolina may have found a way to narrow the gap between rising health care costs and declining health outcomes. In this special report, the authors describe how an innovative system of community health networks led by local primary care physicians is improving quality of care and saving the state at least $160 million in Medicaid costs annually.

The program, Community Care of North Carolina (CCNC), includes about 1,200 primary care practices across North Carolina, which manage the care of about 750,000 Medicaid patients roughly 80 percent of the state Medicaid population or almost 10 percent of the North Carolina population.

As described, this payer-practice collaboration offers a modified version of the "medical home" concept where patients are assigned to a primary care home that provides comprehensive longitudinal care, where case managers provide wrap-around services, where practice-specific data are used to improve care, where patients learn from each other and where community partners support care.

Conservative modeling indicates CCNC saved the state of North Carolina $60 million in fiscal year 2003. By 2006 just eight years after the program was implemented savings had increased to $161 million annually, with more liberal modeling putting the cost savings at more than $300 million annually by 2006. The largest savings were achieved in emergency department utilization (23 percent less than projected), outpatient care (25 percent less than projected) and pharmacy costs (11 percent less than projected).

Beyond saving money, CCNC has also improved quality of care, as illustrated by increased asthma control, one of the program's first initiatives. Two years after implementation, chart audits showed a 16 percent increase in asthma staging, and 90 percent of stag
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Contact: Angela Sharma
asharma@aafp.org
913-269-2269
American Academy of Family Physicians
Source:Eurekalert

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