Patient-Centered Medical Home

1. Patient-Centered Medical Home

11. PROTECT PROMOTE IMPROVE

12. Patient Centered Medical Homes:Keeping People Healthy and Controlling Health Care costs Ted Wymyslo, MD Director Ohio Department of Health ProMedica Oct. 31, 2011

13. Ohio’s Health System Performance Health Outcomes – 42nd overall1 • 42nd in preventing infant mortality (only 8 states have higher mortality) • 37th in preventing childhood obesity • 44th in breast cancer deaths and 38th in colorectal cancer deaths Prevention, Primary Care, and Care Coordination1 • 37th in preventing avoidable deaths before age 75 • 44th in avoiding Medicare hospital admissions for preventable conditions • 40th in avoiding Medicare hospital readmissions Affordability of Health Services2 • 37th most affordable (Ohio spends more per person than all but 13 states) • 38thmost affordable for hospital care and 45thfor nursing homes • 44thmost affordable Medicaid for seniors Sources: (1) Commonwealth Fund 2009 State Scorecard on Health System Performance (2) Kaiser Family Foundation State Health Facts (updated March 2011)

14. Half Put Off Care Due to Cost Percent who say they or another family member living in their household, have done each of the following in the past 12 months because of the cost: Skipped dental care or checkups Relied on home remedies or over-the-counter drugs instead of going to see a doctor Put off or postponed getting health care needed Not filled a prescription for a medicine Skipped a recommended medical test or treatment Cut pills in half or skipped doses of medicine Had problems getting mental health care ‘Yes’ to any of the above Source: Kaiser Family Foundation Health Tracking Poll (conducted March 8-13, 2011)

15. Medical Hot Spot:Emergency Department Utilization: Ohio vs. US Hospital Emergency Room Visits per 1,000 Population 29% Source: American Hospital Association Annual Survey (March 2010) and population data from Annual Population Estimates, US Census Bureau: http://www.census.gov/popest/states/NST-ann-est.html.

16. SOURCE: Adapted from Melanie Bella, State Innovative Programs for Dual Eligibles, NASMD (November 2009)

17. Patient-Centered Medical Homes • Primary Healthcare Provider • Whole Person Orientation • Care is Coordinated and/or Integrated • Quality and Safety are Hallmarks • Enhanced Access • Payment for Value

18. PCMH Insurers Employers Patients Providers

19. Blended Reimbursement

20. Ohio Patient-Centered Primary Care Collaborative • Facilitatedbythe Ohio Department of HealthResponsibilities: • Coordinates communication among existing Ohio PCMH practices • Facilitates statewide learning in collaborative PCMH practices in Ohio • Facilitates new PCMH practice startup in Ohio • Shapes policy in Ohio for statewide PCMH adoption

21. The End Goal: Health Care Consumers that are Involved in Their Care • Better Care Coordination: Providers interact with their patients on a continual basis • Electronic Connectivity: Providers communicate with each other and their patients about their care • Patient Navigators: More care happens outside the provider’s office through the patient navigator • Payment reform: providers are incented and reimbursed for keeping their patients healthy

22. Contact Information Ted Wymyslo, M.D. Director, Ohio Department of Health (614) 466-2253 Ted.Wymyslo@odh.ohio.gov