UH Med Now

JAMA article looks at PCP payment “transformation:” Cost savings inconclusive, but HMSA says “we’re on the right track”

Date: July 14th, 2019 in Care, Research    Print or PDF

MD students with signs supporting primary care physicians

Pictured: Class of 2019 MD students Ashley Morisako, Kat Roberts, Sean Awakuni, and Aaron Suzuka at a Primary Care Workforce Crisis Meeting at JABSOM in 2018.

By UH Med Now

The Journal of the American Medical Association (JAMA) this month published a study about HMSA’s pilot program to transform primary care in collaboration with providers in Hawaiʻi .

The study, led by researchers affiliated with the University of Pennsylvania, found the “3PC capitation-based primary care payment system in Hawaiʻi was associated with small improvements in quality and a reduction in visits to Primary Care Provider.” However, the authors found no significant difference in the total cost of care, noting that additional research is needed to assess longer-term outcomes as the program is more fully implemented and to determine whether results can be adapted to other health care markets.

Researchers reported small improvements in quality, a reduction in PCP visits, but no significant difference in the total cost of care.

HMSA found the results both positive and encouraging. “Sometimes, a single, strategic, focused change in how things get done can change everything,” said HMSA President and CEO Michael B. Stollar in a news release issued by HMSA.

According to HMSA, the pilot began in 2016 as a partnership between HMSA and 107 primary care providers on Oʻahu and Maui with the goal of replacing the traditional fee-for-service model with a single monthly payment for every HMSA patient in that provider’s practice.

“We’re now four years into the program. The JAMA publication, recent adaptation of this model by the Centers for Medicare & Medicaid Services (CMS), brand-new CMS data showing that Hawaii doctors provide the best care to Medicare patients the in the nation, and data from the study and our participating providers confirm that we’re on the right track,” Stollar said.

Said Mark M. Mugiishi, M.D., F.A.C.S., HMSA executive vice president and chief health officer “We see this moment as a confirmation and motivation to keep going — keep improving and getting it right.”

Read the abstract from JAMA.

Share this: