Medicaid Medical Home Project Saves ½ Billion over Two Years Gordana Krkic, CAE Vince Keenan, CAE Illinois Academy of Family Physicians.

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Presentation transcript:

Medicaid Medical Home Project Saves ½ Billion over Two Years Gordana Krkic, CAE Vince Keenan, CAE Illinois Academy of Family Physicians

Best kept secret now revealed Find out how Primary Care Case Management project and Disease Management projects led by primary care physicians for primary care practices has saved Illinois $500 million over FY 2008 and FY 2009 This activity may be replicable in your state More research being done to quantify and qualify best practices

Illinois demographics 12.9 million people ¾ live in northeast section of state (Chicagoland) 14% foreign born 80% white; 16% black; 4% Asian 20% speak language other than English

The beginning Fall 2005, then Governor announces All Kids program, first state to provide universal access for all children Spring 2006, state Medicaid program lets RFPs for PCCM and DM projects Summer 2006, Automated Health Systems and McKesson Health Solutions successful bidders for PCCM and DM, respectively

The launch Medical homes recruited. Fall 2006, 5100 medical homes, practices choose how many Medicaid patients they will take 5.1 million slots identified for 1.5 million patients January-November 2007, all eligibles enrolled in medical homes

Guided by primary care Steering committee started at outset meeting monthly for first two years, moved to every six weeks in third year, and met quarterly starting in fourth year. Illinois Medicaid program engaged providers in strategic planning and decision-making

Results roll in FY 2008 PCCM and DM in full force for last six months = $180 million in savings FY 2009 First full year of operations = $320 million in savings

Where were the savings? Decreased hospital admissions Shortened hospital stays Decreased emergency room use

Provider and patient satisfaction is high Annual provider survey results rank programs at 97% satisfaction rate, a significant improvement over provider attitudes before program existed. Annual patient survey highlights patients’ satisfaction.

Minimal Media Attention Feature articles appeared in: May 19, 2009 Springfield Journal-Register April 27, 2010 Crains Chicago Business article

Current status (June 2010) 2 million patients and 5700 medical homes; 200,000 in managed care, rest in FY ‘10 results will be available in March ‘11 Disease Management contract up in June ‘11 Primary Care Case Management contract up in June ‘12

Evaluation 1 No formal evaluation in either PCCM or DM Republicans would rather have managed care IAFP, with funding from Community Memorial Foundation, and Michael Reese Health Trust, engaged Graham Center, center.org to write case statement and create RFPwww.cmfdn.orgwww.healthtrust.netwww.graham- center.org

Evaluation 2 Two proposed projects A. Fiscal analysis of PCCM, B. Study of high performing and low performing practices Hope to be completed by Feb 2011 to help inform next steps

For more information Illinois PCCM, Margaret Kirkegaard MD, medical director, Illinois Health Connect, Illinois DM, Carrie Nelson, MD, medical director, Your Healthcare Plus, Illinois Academy of Family Physicians, Graham Center, Robert Phillips, MD, MSPH, director,

Your presenters Gordana Krkic (Ker-kitch) CAE, Deputy EVP Vince Keenan, CAE, EVP Illinois Academy of Family Physicians 4756 Main St., Lisle, IL (Gordana) (Vince)