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Archive for the "Medicare/Care Coordination" category

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 [...]

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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 [...]

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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 [...]

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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 [...]

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Lifemasters Bankruptcy: Will CMS Earn Reputation as a Good Business Partner or Thug?

In my post from Monday on LifeMasters seeking Chapter 11, I dropped a BTW comment. The part that’s puzzling to me is the statement that LifeMasters owes $125 M to CMS.  That’s hard to figure…the company only participated in MHS for a few months, and to my knowledge MHS is the only Medicare demo that required guaranteed [...]

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Medicare Health Support (MHS) Claims Another Victim: LifeMasters Files for Chapter 11

Updated 6:10 pm, September 14, 2009 One bad deal can ruin your day. Today, LifeMasters filed for Chapter 11 bankruptcy protection.  According to its press release: “The Chapter 11 filing is the most efficient path for the company to restructure liabilities that are a result of Demonstration Projects previously performed under contracts with the Centers for [...]

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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 [...]

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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 [...]

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Landmark Report: “The Promise of Care Coordination” in Medicare

Download a copy here .  Excerpts from the Executive Summary: Effective Interventions Three types of interventions have been demonstrated to be effective in reducing hospitalizations for Medicare beneficiaries with multiple chronic conditions who in general are not cognitively impaired: Transitional care interventions in which patients are first engaged while in the hospital and then followed [...]

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