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IBD specialty medical home relies on psychiatrist, insurer to succeed


 

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To that end, Dr. Regueiro said he hopes the center will expand its use of telemedicine to further accommodate patients, who often find it difficult to take time off from work or school, find and afford child care, and travel long distances to their doctor appointments. “Right now, some patients have to drive hours to see us, but a lot of what we do for these patients is cognitive care,” he said.

The IBD center’s additional personnel have been paid for by the health plan, in order to cover the cost of adequately serving the approximately 725 IBD patients the insurer determined were the most expensive to treat out of the more than 5,000 IBD patients, a notably high number according to Dr. Szigethy, that the center serves.

In exchange for underwriting the cost of a portion of the staff, the health plan expects Dr. Regueiro and his team to cut treatment costs for this cohort. “If we save a certain amount on patients each year, the health plan will give that back to us,” Dr. Regueiro said.

One way Ms. McAnallen said the program is projected to save is by reducing the number of times frequent fliers of UPMC’s emergency department arrive with an IBD complaint.

“The ED specializes in all acute medical issues, but for IBD we need to focus in a different way,” said Ms. McAnallen.

To wit, in her health care high-utilization heyday, Anne’s treatment typically began in the emergency department, where she arrived seeking narcotics for her condition.

“She said she hated that the people in the ED treated her like a drug addict, but she hated the pain even more,” Dr. Regueiro told his Orlando audience.

This was particularly troublesome for Anne, since Dr. Szigethy determined she was a potential sufferer of narcotic bowel syndrome.

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