"Our whole premise is that if we implement a model that takes a proactive approach and changes the way primary care is practiced, we will improve patient care . . . and ultimately save money," said Phil Magistro of the Governor's Office of Healthcare Reform, which is leading the effort.
For some experts, the approach is strikingly similar to past failures.
"In many ways, it is a return to the idea of integrated delivery, which is the original concept behind HMOs," said Mark V. Pauly, professor of health-care management at the University of Pennsylvania's Wharton School. "I doubt it would save money. . . . The best we can hope is that it will improve the quality of care."
The proposal comes as health costs keep rising. Health insurance keeps getting more expensive. And employers are continuing to cut benefits by raising co-pays or eliminating coverage. One factor driving these costs is the expensive care of people with chronic conditions, such as diabetes and asthma.
The initiative starting today is the first phase of Gov. Rendell's chronic-care model for Pennsylvania, which is expected to go statewide this fall.
The effort is part of Rendell's ambitious Prescription for Pennsylvania proposal, which seeks to expand access to health coverage for the uninsured and reduce medical errors. While the health-insurance expansion has stalled in the legislature, the quality initiatives have moved ahead since they were first proposed in January 2007.
The goal in chronic care is now to transform the way all primary care is delivered and how it is paid for.
Instead of the traditional way - paying by the procedure - the program will reward caregivers for how well they dispense proven treatments and keep patients healthy.
