Wednesday, June 20, 2012

PBGH Receives CMS Award

The CMS Innovation Center announced the second and final batch for the Health Care Innovation Awards. The project awards are part of a total of 107 projects representing innovators from 50 states, District of Columbia, and Puerto Rico. The awards support innovative projects nationwide designed to deliver high-quality medicine and lower costs and target many issues.

One of the awards for $19 million went to the Pacific Business Group on Health (PBGH) in California. PBGH will use the funding to start an initiative to improve care for 23,000 Medicare patients in the state living with multiple chronic conditions while dramatically lowering the cost of care. PBGH will operate the new initiative relying heavily on their sister organization California Quality Collaborative (CQC).

The program called “Intensive Outpatient Care Program” will be delivered by PBGH and CQC plus they will work closely with a number of experts and 17 medical group partners in California. The objective is to spread intensive care management for high-risk Medicare beneficiaries across their network of 9,000 primary care practices.

The new program will use well trained care managers embedded in high performing primary care teams to develop close relationships with medically complex patients. The team will deliver highly individualized and accessible primary care based on treatment goals specific to each patient. The goals are to have fewer patients make emergency room visits, avoid hospitalizations, and reduce complications.

The goal is to reduce the cost of care by five percent while improving the care of the beneficiaries and also reduce patient reported experience with care by at least two percent annually.

“This is really about taking some proven models from the private sector and making them work to help improve the health of Medicare patients. This is a powerful private-public sector partnership and we are excited to get started,” said David Lansky, CEO of PBGH.

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