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Montana-Made Solution for Rising Health Costs Takes Big Step Forward

Lindeen approves guidelines for reforming primary care statewide

January 24, 2012

HELENA, Mont. – Commissioner of Securities and Insurance Monica J. Lindeen today approved the recommendations of her advisory council on patient-centered medical homes, marking the next major step toward a new, Montana-made solution for lowering health care costs, improving access to quality care, and achieving better health outcomes across the state.

"I appreciate the hard work the advisory council has committed to these essential pieces of the project," said Lindeen. "The quality standards and framework for payment are significant steps toward our goal of implementing a Patient-Centered Medical Home Program in Montana that achieves high-quality care, lower costs, and consistency in health care delivery across Montana."

Lindeen created an advisory council last August to make recommendations on how Montana can implement a patient-centered approach to health care delivery. The council's recommendations included a set of standards, like body mass and blood pressure, which medical practices can use to assess quality improvement. New payment guidelines would reward healthy outcomes. The council's extensive set of quality standards will be used as the building blocks for a future pilot project.

The council's recommended framework for payment aims to create a medical system that rewards providers for coordinating care for chronic disease, improving results for patients, and reducing total cost of care. The framework will serve as a guideline for insurance companies and providers to use when they create payment contracts under the medical home model.

"Doctors, insurers, and patient advocates don't always see eye to eye, and the fact that we've come this far in such little time is a testament to what reasonable people can accomplish when presented with a problem," said Lindeen. "I hope that the next legislature recognizes the long hours and hard work it took to build this consensus and quickly passes legislation to start testing these guidelines in a statewide pilot project."

The Commissioner's office will continue working with the council as they shift their focus to producing a bill for the 2013 legislative session to structure a statewide medical home pilot project. The Commissioner will also ramp up education efforts for primary care providers about how and why they should transform their practice into a patient-centered medical home.

For more information about the Commissioner's patient-centered medical homes project, call 800-332-6148 or visit www.csi.mt.gov/MedicalHomes.