Deciding

Deciding

Questions to Consider Before Deciding to Participate

  • How does my members’ benefit plan design work with HCH payment models?
  • Are there changes to my benefits that could enhance member’s use of primary care and HCHs?
    • Do we cover e-visits, web visits or phone?
    • What is my member costs for care of chronic conditions?
  • What percentage of my population has a primary care provider?
    • Do members have incentives to seek primary care first?
    • Do members have enough information to select a primary care provider if needed?
  • What percentage of my population, has a chronic condition, is complex/high risk and could benefit from seeking care from a HCH?
    • How could those who would benefit the most receive the benefit of HCHs?
  • What percentage of costs is paid to primary care providers, emergency rooms, hospital care, and specialists?
    • What would be the impact if I increased the amount paid to primary care by 20%?
    • What impact would that have on inappropriate care and its costs?
  • What is my rate of “avoidable” and inappropriate emergency room visits and hospitalizations?

 

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