Aetna Foundation Directs $1 Million to Measure Effectiveness of Integrated Health Care Models

HARTFORD, Conn.--(BUSINESS WIRE)--Finding effective ways to repair the fragmented U.S. health care system to improve quality and patient safety are goals of four grants announced today by the Aetna Foundation. The Aetna Foundation will fund four research projects intended to assess new health care delivery designs that promote integrated health and patient-centered medical homes.

“Many of the highest-performing health care providers achieve great outcomes by offering well-integrated health care and serving as a medical home for patients”

Integrated health care is a comprehensive health care service delivery system, based on strong, well-coordinated primary care, that many health care experts believe can improve patient health and safety, particularly for patients with chronic conditions. Experts also believe such integrated health care can help minimize racial and ethnic health care disparities and lower health care costs.

The Aetna Foundation made grants totaling $1 million to separate studies by Baylor College of Medicine; Massachusetts General Hospital; the University of California, San Francisco; and the University of Florida.

“Many of the highest-performing health care providers achieve great outcomes by offering well-integrated health care and serving as a medical home for patients,” said Anne C. Beal, M.D., M.P.H., president of the Aetna Foundation, who has published widely on health care issues. “The most effective primary care providers manage and coordinate care from specialists, therapists, hospitals and other providers, which ensures good communication among all parties and keeps the patient involved and informed. This coordination role is especially important for patients with chronic or complex health conditions, since most of their health care is managed by primary care providers.

“While we know that well-integrated and well-coordinated care can have a host of benefits – improved health outcomes, better patient experiences, lower costs and fewer medical errors – we do not fully understand the links between good coordination and good outcomes nor have we identified the best pathways to achieving strong care coordination. We believe the studies we are supporting can help bring forth models of integrated health care that will lead to healthier patients and lower costs,” said Beal.

The four research grants are:

$250,000 to Baylor College of Medicine in Houston, Texas, to study how primary care medical homes can lower the cost of care and improve the health of children with chronic physical, developmental or behavioral conditions. Upwards of 16 percent of American children are estimated to have special health care needs, and their care accounts for 42 percent of medical expenditures on children in the U.S. Using Medicaid/Children’s Health Insurance Program (CHIP) data for Houston-area children, the researchers will identify a diverse group of children with special health care needs and survey their doctors about the children’s treatment and coordination of their care. To obtain the patient perspective, the researchers will survey the children’s parents about their satisfaction with their youngster’s care. Additionally, the researchers will analyze claims data to see if the children treated by doctors who identify their practice as a primary care medical home have fewer emergency room visits, hospitalizations and other potentially avoidable treatments than children who receive their care from other types of medical practices. The two-year study is being led by Jean Raphael, M.D., M.P.H., assistant professor of pediatrics at Baylor.
$250,000 to Massachusetts General Hospital (MGH) in Boston, Mass., to study whether intensive care management and integrated care can improve the health outcomes of economically disadvantaged patients with multiple chronic conditions while decreasing the cost of their treatment. The research team, led by Lisa I. Iezzoni, M.D., M.Sc., professor of medicine at Harvard Medical School and director of the Mongan Institute for Health Policy at MGH, will evaluate a new integrated primary care program launched in 2010 by Cambridge Health Alliance that serves a diverse population of low-income children and adults with two or more chronic conditions. The Massachusetts-based program assigns each patient to a primary care doctor who coordinates treatment, and, as needed, adds an interdisciplinary team of nurse practitioners, clinical nurse psychologists, social workers and community health workers to help patients manage their health. The two-year study will examine the barriers in implementing the program, assess patient satisfaction with the program’s care coordination, communication and quality, and quantify the cost of care.
$250,000 to the University of California, San Francisco (UCSF) for a two-year study to create a rigorously tested survey tool to assess integrated care around the country. The research will be among the first to develop metrics of integrated care based on the needs, experiences and expectations of patients with chronic conditions. By focusing on the patient experience to create measurements of integrated care practices, the researchers expect their measurement tools to assess these concepts more systematically among diverse patient populations and in a wide range of practice settings. Based at San Francisco General Hospital and Trauma Center (SFGH), the research is being co-led by Kevin Grumbach, M.D., chair of the UCSF Department of Family and Community Medicine and Chief of Family and Community Medicine at SFGH, and Kara Odom Walker, M.D., M.P.H., assistant professor at UCSF and a physician at SFGH Family Health Center.
$250,000 to the University of Florida in Gainesville for a two-year study exploring whether primary care medical homes can improve the health of patients with diabetes. Currently, 24 million Americans are living with diabetes, a chronic disease that requires patients to take an active role in monitoring their diet and glucose levels to manage the disease successfully. The researchers, led by Allyson Hall Ph.D., associate professor in the Department of Health Services Research, Management and Policy at the University of Florida’s College of Public Health and Health Professions, will examine if the primary care medical home model increases patient engagement with managing their diabetes and if increased patient engagement leads to better health. Four Jacksonville, Fla., patient-centered medical home practices, each serving a racially and socio-economically diverse population, will be the sites of the research.

Integrated care is one of the Aetna Foundation’s three program areas, along with fighting obesity and promoting racial and ethnic equity in health and health care. Recently, the Aetna Foundation helped sponsor a December 2010 Health Affairs conference featuring 15 presentations on innovations in health care delivery. Articles based on the conference presentations were published in the journal’s March 2011 issue. In addition, the Aetna Foundation recently announced a grant to RAND Health for a research study to examine the financial and health impacts of poorly coordinated care.

About the Aetna Foundation

The Aetna Foundation, Inc. is the independent charitable and philanthropic arm of Aetna Inc. Since 1980, Aetna and the Aetna Foundation have contributed $394 million in grants and sponsorships, including $15.6 million in 2010. As a national health foundation, we promote wellness, health, and access to high-quality health care for everyone. This work is enhanced by the time and commitment of Aetna employees, who have volunteered more than 2.3 million hours since 2003. Our current giving is focused on addressing the rising rate of adult and childhood obesity in the U.S.; promoting racial and ethnic equity in health and health care; and advancing integrated health care. For more information, visit www.AetnaFoundation.org.