HELENA – Hospitals, physicians, health insurers and health clinics came out in force Wednesday to support a bill encouraging “patient-centered medical homes,” which are medical practices designed to offer preventive care and reduce health care costs.
No one testified against Senate Bill 84, which would set up a commission to oversee standards for the new practice model and protect them from antitrust lawsuits.
“As we all know, medical costs are out of control,” said Sen. Christine Kaufmann, D-Helena, the chief sponsor of the bill. “These are the best practices that are being developed out there across the country, to sort of get control (of costs).“
The Senate Public Health Committee took no immediate action on the measure, and both Kaufmann and state health officials said they would offer amendments to fix some minor concerns with the measure.
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Yet panel members asked plenty of questions about the new clinic model, such as how it would work, how and whether it would save money and why the state needed to be involved in what’s a private sector undertaking.
Douglas Carr, an internist at the Billings Clinic, said a medical home can be as small as a partnership of two physicians or one like Billings Clinic, with more than 60 primary care physicians.
The medical home agrees to manage its patients, not only seeing them when they are sick but also making sure they are getting proper preventive treatment, such as cancer screenings and chronic disease management.
In exchange, the insurer agrees to pay the clinic a per-patient, per-month fee on top of its usual payments for service, he explained.
“There is an investment by this practice in (extra) people who are taking care of patients who aren’t there in the office that day,” Carr said. “That’s the key between population management and ‘sick care.’ … A stich in time saves nine.“
Fred Olson, a physician and medical director for Blue Cross and Blue Shield of Montana, the state’s largest private health insurer, said his company believes that the savings will come from reduced use of the emergency room or other hospital services.
Olson said Blue Cross already has arrangements with nine patient-centered medical homes that have 300 health care providers.
Sen. Art Wittich, R-Bozeman, asked why the private parties couldn’t just work out the details, without involvement from the state.
Christina Goe, chief counsel for state Auditor Monica Lindeen, whose office developed the bill, said insurers and the medical homes could be open to accusations of setting prices if they agree to a common payment framework.
The bill shields them from antitrust lawsuits, because it provides some state oversight of the process and says there is a “state purpose” to encouraging medical homes, she said.
SB84 creates a commission of medical professionals, insurers and consumers that will set standards for health-care providers that want to create a medical home.