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Related Experiment Videos

Primary care for persons with disabilities. The Boston, Massachusetts model program

A R Meyers1, M Glover, R J Master

  • 1School of Public Health, Boston University School of Medicine, Massachusetts 02118-2394, USA.

American Journal of Physical Medicine & Rehabilitation
|May 1, 1997
PubMed
Summary

Boston's Community Medical Group (BCMG) pioneered prepaid managed care for individuals with major disabling conditions. Their extensive experience shows this model is feasible, ensuring quality outcomes and promoting patient autonomy.

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Area of Science:

  • Healthcare Management
  • Primary Care Innovation
  • Managed Care Models

Background:

  • Boston's Community Medical Group (BCMG) is a pioneering primary care practice.
  • BCMG has extensive experience, exceeding one thousand person-years.
  • The group has focused on serving individuals with major disabling conditions.

Purpose of the Study:

  • To evaluate the ethical and operational feasibility of prepaid managed care for disabled populations.
  • To assess the viability of risk-sharing models between providers and payers.
  • To determine if this care model supports independent living and consumer autonomy.
  • To verify the achievement of high-quality clinical outcomes at reasonable costs.

Main Methods:

  • Longitudinal experience analysis of a community-based primary care group practice.

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  • Implementation and assessment of a prepaid capitated care model.
  • Focus on nurse-practitioners as primary care providers.
  • Integration of principles supporting independent living and consumer autonomy.

    • Main Results:

    • Demonstrated ethical and operational feasibility of prepaid managed care for major disabling conditions.
    • Successful implementation of financial risk-sharing with providers.
    • Reinforcement of independent living principles and consumer autonomy.
    • Achievement of high-quality clinical outcomes within reasonable cost parameters.

    Conclusions:

    • Prepaid managed care for individuals with major disabling conditions is ethically and operationally feasible.
    • The BCMG model successfully balances quality care, cost-effectiveness, and patient empowerment.
    • This approach offers a sustainable framework for managing complex health needs within the community.