A personalized preventive care model versus a traditional practice: comparison of HEDIS measures

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Published: Dec 6, 2012
DOI: https://doi.org/10.5750/ijpcm.v2i4.305
Keywords:
HEDIS measures MDVIP personalized care prevention primary care

Main Article Content

Ralph E Seligmann
MDVIP-affiliated private practice physician, Scottsdale
Lawrence P. Gassner
MDVIP-affiliated private practice physician, Phoenix, AZ
Ned D. Stolzberg
MDVIP-affiliated private practice physician, Glendale
Nisal K. Samarasekera
MDVIP-affiliated private practice physician, Glendale
Kimberly Warth
MDVIP Inc., 300 Boca Raton, Florida
Andrea Klemes
Medical Director of MDVIP, MDVIP Inc., 300 Boca Raton, Florida

Abstract

Objective:  The objective of the study was to assess the impact of the MDVIP primary care model that focuses on personalized preventive healthcare and to compare the rates of HEDIS effectiveness of care measures from the MDVIP model to national health plan results.Methods:  We performed a retrospective chart review of 15 MDVIP-affiliated Arizona physicians and used descriptive statistics (percentages) to compare the average rates of each of the HEDIS measures from our chart review to the 2010 national health maintenance organization (HMO) and preferred provider organization (PPO) health plans average rates published by the National Committee for Quality Assurance (NCQA). Results:  357 members (41.5% men, 70.9% age > 65 years) identified as having a diagnosis of uncomplicated diabetes, hyperlipidemia, hypertension or atrial fibrillation were included.  A higher percentage of MDVIP members with Diabetes Mellitus had good blood pressure control (<140/90), LDL-C levels <100 and eye exam rates as compared with the national health plan rates.  The majority (>93%) of MDVIP members had “good” HbA1c (<8%) control, which was much higher than the national HMO (~64%) and PPO (~55%) plan reported rates.  A higher percentage of MDVIP members with cardiovascular conditions had LDL-C screenings (~96%) performed compared with national HMO (89%) and PPO (~84%) plan rates.  A higher percentage of MDVIP members had mammograms (87%) and colonoscopies (85%) performed as compared with national HMO and PPO plan rates.    Conclusions:  These results support our belief that the MDVIP primary care model delivers better preventive care services when compared to national health plans.

Article Details

Issue
Vol. 2 No. 4 (2012)
Section
Regular Articles

References

Chen, L.M., Farwell, W.R. & Jha, A.K. (2009). Primary care visit duration and quality: does good care take longer? Archives of Internal Medicine 169, 1866-1872.

Yarnall, K.S., Pollak, K.I., Østbye, T., Krause, K.M. & Michener, J.L. (2003). Primary care: is there enough time for prevention? American Journal of Public Health 93, 635-641.

Østbye, T., Yarnall, K.S., Krause, K.M., Pollak, K.I., Gradison, M. & Michener, J.L. (2005). Is there time for management of patients with chronic diseases in primary care? Annals of Family Medicine 3, 209-214.

Kottke, T.E., Brekke, M.L. & Solberg, L.I. (1993). Making "time" for preventive services. Mayo Clinic Proceedings 68, 785-791.

Campion, E.W. (2001). A symptom of discontent. New England Journal of Medicine 344, 223-225.

Pollak, K.I., Krause, K.M., Yarnall, K.S., Gradison, M., Michener, J.L. & Østbye, T. (2008). Estimated time spent on preventive services by primary care physicians. BMC Health Services Research 8, 245.

French, M.T., Homer, J.F., Klevay, S., Goldman, E., Ullmann, S.G. & Kahn, B.E. (2010). Is the United States ready to embrace concierge medicine? Population Health Management 13, 177-182.

NCQA (National Committee for Quality Assurance). (2011). State of Healthcare Quality Report 2011. Washington, DC: NCQA.