My former employer is bragging about research recently published by a Pitt Med School professor. She is looking at the changes in cost of care for Veterans Administration patients because of a new integrated care model.
The VHA launched its Patient Aligned Care Teams (PACT) initiative in 2010, the largest program in the country to implement patient-centered medical home care. The VHA assigned each of the network’s 5 million primary care patients to a “teamlet” designed to provide multidisciplinary health care support focused on patients’ individual needs…..
a team of researchers… analyzed medical records from all 808 participating clinics
The 77 clinics that most fully executed the PACT model by 2012 had significantly larger improvements in five of seven chronic disease outcome measures and two of eight clinical process measures compared to the 69 clinics with the fewest PACT elements implemented. Researchers found that clinics with the most advanced PACT implementation saw 1 to 5 percent more of their patients meeting established levels for diabetes, blood pressure and cholesterol control.
1% to 5% improvements are not nothing. That is valuable. It makes the lives of those patients much better and it could conceivably lead to lower costs. It is also not a home run. It is not even a hard hit double that bounced around the wall near the power alleys. Instead it is a bloop single that landed in the grass halfway between the slap hitting second basemen and the no defense right fielder and the ball just died there.
Consistently being able to generate seeing eye singles can be an element of a long career as long as that player is able to add value somewhere else. It is not a hall of fame or system changing skill set though. In the same way, coordinating care helps on outcomes, it helps on process, it might help on costs and it may make the lives of patients better and easier at the same time. It probably won’t meaningfully bend the cost curve.