Two local health care organizations are part of interstate collaborations that have pledged a 243 percent return on new innovation grants from the federal Centers for Medicare and Medicaid Services.
Leawood-based TransforMED, a nonprofit subsidiary of the American Academy of Family Physicians, and Truman Medical Centers are part of separate initiatives that received a combined $35.1 million in grants earlier this month.
The grantees estimate that the projects will improve efficiency and save the health care system approximately $120.5 million during the next three years. More broadly, the grant program aims to establish replicable models for use across the country.
Overall, the center awarded approximately $900 million to 107 projects (innovations.cms.gov/initiatives/innovation-awards/project-profiles.html). The agency received approximately 3,000 applications.
TransforMED, which provides consulting to physician practices, is leading an effort to expand the patient-centered medical home concept into what it calls a “medical neighborhood.”
In patient-centered medical homes, primary care physicians actively manage the health of their patients as opposed to just treating them when they are sick. The goal is to ensure that small problems do not mushroom into worse — and more costly — conditions and to keep chronic conditions in check.
The TransforMED medical neighborhood project incorporates hospitals, specialists and other providers to the patient-centered mix in 16 markets across the country, including Via Christi Health in Wichita.
“Everybody knows that primary care by itself can’t solve all the cost and quality issues that are facing the U.S. health care system,” said Dr. Terry McGeeney, president and CEO of TransforMED.
TransforMED’s partners are Dallas-area firms VHA Inc. and Phytel.
VHA is a nationwide network of more than 70,000 nonprofit providers that collaborate in areas such as purchasing and clinical performance. Phytel is a developer and provider of electronic health record technology.
The partners particularly wanted a Kansas site, McGeeney said, because the state lacks well-established networks between independent physicians and hospitals.
The partners and CMS identified the 16 participating sites based on factors that included size and geographic diversity, said Dr. Peggy Naas, VHA’s vice president for physician strategies.
A patient-centered medical home is great, Naas said, but it becomes an “isolated jewel of wonderfulness” without good connections to other providers.
Plans call for approximately six primary care practices to participate in each market.
Naas said she hoped that mental health and dental providers would be part of the medical neighborhoods. Those are two services that safety net providers say underinsured and uninsured patients need most.
She said uninsured patients also might benefit from this well-connected system when, for instance, an individual makes an emergency room visit and a care coordinator determines that he or she qualifies for public health benefits.
Truman Medical Centers, along with other local partners, is participating in a grant administered by the Center for State Health Policy at Rutgers University in New Brunswick, N.J.
The effort will build upon two Truman programs, Guided Chronic Care and Passport to Wellness, that provide comprehensive services, including social workers, aimed at improving the health of high-utilization patients. Guided Chronic Care, for instance, focuses on heart failure patients.
Communities Creating Opportunity, a faith-based organization in Kansas City, Mo., is also participating through its program to reduce reliance on high-cost emergency care in certain ER hot spots within the city (https://hcfgkc.org/news/reliance-emergency-rooms-signals-failure-health-care-system).
Since they began in April 2010, the two Truman programs have enrolled 186 patients, according to Dr. Shauna Roberts, corporate quality medical director.
The innovation grant calls for expanding services to an additional 750 patients.
Other communities participating in the Rutgers grant are Allentown, Pa., Aurora, Colo., and San Diego.
Lessons learned from the grant program should benefit more than just disadvantaged individuals, Roberts said.
“If we can figure out how to do this with some of the most vulnerable and disadvantaged people,” she said, “we will have learned some things that are replicable and helpful for other people when they have health care needs when they are vulnerable.”
For instance, she said, “When I’m 95 and ill, I want someone there like this for me.”