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Cost-Saving Health Care Program Launches

Lindeen’s market-driven approach proves early success

March 4, 2014

HELENA. – Nearly thirty medical practices across Montana are participating in a cost-saving new program run by Montana Insurance Commissioner Monica J. Lindeen that has been shown to reduce healthcare costs while keeping patients healthier.

Some 29 Montana medical practices are now qualified Montana “patient-centered medical homes,” under the new Montana Patient-Centered Medical Home Program (PCMH), with 43 more practices provisionally qualified. The program is the first of its kind in Montana created by the 2013 Legislature at Lindeen’s request.

“Medical spending goes up every year in this country and it’s time to do more than just talk about it,” Lindeen said. “I am done talking. Patient-centered medical homes are shown to actually reduce costs. This program and the medical practices that have joined it are on the front lines of changing the way medicine is delivered in Montana.”

The “medical home” concept is a different way of approaching health care by paying health care providers for keeping patients healthy. Traditionally, providers are paid to treat illness and injury, providing incentives for excessive treatment, tests, and medication and leading to greater cost throughout the health care system. A PCMH is not an actual place, but a team of health care professionals collaboratively focused on keeping patients healthy through preventive medicine and management of chronic diseases like diabetes and hypertension. Through more efficient delivery, a PCMH improves access to care, increases satisfaction, and improves health outcomes for patients and communities. This kind of coordinated care eventually leads to fewer hospitalizations and emergency room visits.

The Montana PCMH Act set standards for health insurance companies and health care providers, establishing accountability for better health outcomes and lower costs. The law also allows for multiple insurance companies to share in the cost of transforming medical practices into PCMHs. The PCMH Act established government oversight from the insurance commissioner, allowing input from all interested parties through an appointed stakeholder council.

Lindeen’s office has been in the process of setting these standards and recently qualified the patient-centered medical homes in the state. A list of all the qualified medical homes and more about the program can be found here on our website. Those medical homes must report to Lindeen’s office next year on how well they improved the health of their patients.