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Medicare Medical Home Demonstration

Medicare MAPCP Medical Home Demo: CMS Kicks Sands in the States’ Faces

by Jaan Sidorov, MD and Vince Kuraitis

The Medicare MAPCP (Multi-Payer Advanced Primary Care Practice) demo promised to be Medicare’s Biggest Change in 40 Years…

…but the emerging reality isn’t living up to the promise.

In this post, we’ll discuss:

The Promise
An Overview of the MAPCP Demo
Our Main Takeaway: Emerging Reality Suggests Medicare Will Be a “Difficult” Partner
Conclusion: Think Twice Before Signing Up

1) The Promise

The sandbox metaphor was first used by the National Academy for State Health Policy:

For the 10 or more […]

PCMH and Healthcare Reform: Avoiding Drowning in an Ocean of Opportunity

This article appears in the April 2010 issue of Medical Home News.

First, the good news: There are a lot of pilot and demonstration projects potentially involving the Patient Centered Medical Home (PCMH) in newly enacted Federal health care reform legislation – the Patient Protection and Affordable Care Act (PPACA).

Then, the bad news: There are a lot of pilot and demonstration projects potentially involving the PCMH in the PPACA.

…so many that the PCMH risks being drowned in an ocean of opportunity.

I’d […]

The Real Secret Sauce of Medicare’s Participation in Regional Collaboratives — Network Effects

Last week I asked whether Medicare’s Biggest Change in 40 Years is on the horizon. That post described and discussed implications of Medicare’s new direction for the medical home — the shelving of Medicare Medical Home Demonstration (MMHD) and the refocusing on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI).

In that post I touched briefly on the potential for MAPCI to create effective networks at multiple levels — contracting networks, health IT networks, social and collaborative care networks.  I’d like to expand […]

Three Years Of Medical Home Demonstration Preparation Down the Drain?

Do you remember the scene in the movie Animal House where Bluto Blutarski laments “…seven years of college education down the drain?”

Why aren’t primary care physicians expressing similar laments about  the shelving of the MMHD (Medicare Medical Home Demonstration) in favor of the MAPCI (Multi-Payer Advanced Primary Care Initiative).

My colleague Jaan Sidorov, MD and I pick up on no signs of discontent.  Read our essay “Three Years of Medical Home Demonstration Preparation Down the Drain?” on Dr. Sidorov’s blog.

Medicare’s Biggest Change in 40 Years on the Horizon?

Earlier this week CMS issued a typically cryptic Announcement indicating that they were shelving the Medicare Medical Home Demonstration (MMHD) and instead would focus on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI). My blog post from Tuesday provides details and asks the question “What does all this mean?”

Today’s blog post will tackle:

Medicare’s biggest change in 40 years?
The rise of MAPCI
The fall of MMHD
Implications/discussion

Medicare’s Biggest Change in 40 Years?

CMS Shelves Medicare Medical Home Demonstration

I just received an email from CMS announcing the latest official word on the Medicare Medical Home Demonstration (MMHD):

10/26/2009 – In Washington, the efforts to reform health care and health insurance include proposed legislative language that would have an impact on the Medicare Medical Home Demonstration as described in section 204 of the Tax Relief and Health Care Act of 2006 and amended by section 133 of the Medicare Improvements for Patients and Providers Act of 2008. Specifically, section 1302 of […]

Part II — The Medicare Medical Home Demonstration: Crawling Out From Under the Rock

In Part I of my guest post on The Collaborative Forum blog, I wrote that the Medicare Medical Home Demo is in BIG Trouble. Here’s a recap:

Political reality dictates that the MMHD must save costs.
As currently structured, the MMHD cannot achieve cost savings

In any given year, only a small percentage of patients account for the vast majority of costs
Lessons from previous Medicare disease/care management demonstrations has shown that effective care coordination interventions must be targeted at this population
Medicare has structured the […]

Medicare Medical Home Demo (MMHD) is in BIG Trouble

Between the time the MMHD was authorized in 2006 and now, we’ve learned a lot about what works and what doesn’t work in Medicare care coordination programs. The MMHD is between a rock and a hard place — conflicted by two “must achieve” objectives that are diametrically opposed:

As a political matter, the MMHD must save money
As currently structured, the MMHD cannot save money

Please read my guest post

The Medicare Medical Home Demonstration (MMHD): Between a Rock and a Hard Place

over at […]

Complimentary Issue — Medical Home News

Would you like to receive a complimentary issue of a new publication — Medical Home News ?  Click on the link and then on “Sample Issue” in the upper left corner.

Here’s a preview of the first issue:

Introducing Medical Home News
An Annotated Guide to the Medicare Medical Home Demonstration (MMHD)
Subscriber’s Corner
Johns Hopkins Lipitz Center to Assist Practices in Medical Home Demo
National Medical Home Summit to be Held March 2nd – 3rd 2009
Thought Leader’s Corner
Industry News
Catching Up With… Paul Grundy, MD

I’m honored […]

Medicare Health Support: 8 Takeaways on Building Better Bridges

by Thomas Wilson, PhD, DrPH and Vince Kuraitis

What’s the right metaphor for Medicare Health Support (MHS), CMS’ major experiment with disease management for Medicare beneficiaries?  We prefer to look it as a bridge failure that presents an opportunity to improve future engineering and design.

We’ve now had the time to read, reread, and reread again the very recent report from Research Triangle Institute (RTI) — Evaluation of Phase I of the Medicare Health Support Pilot Program Under Traditional Fee-for-Service Medicare: […]

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