- 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 MMHD so that any patient with one or more chronic condition is eligible; this includes 86% of all Medicare patients.
- Physicians will be paid risk-adjusted care coordination fees for this entire population — the 86% of patients with one or more chronic condition.
The MMHD cannot achieve cost savings.
Dr. Randy Williams, MD — CEO of Pharos Innovations — has written Part II of this series: The Medicare Medical Home Demonstration: Crawling Out From Under the Rock. It’s insightful and provocative reading!
Table of contents for Medicare Medical Home Demo Challenges
- Medicare Medical Home Demo (MMHD) is in BIG Trouble
- Part II — The Medicare Medical Home Demonstration: Crawling Out From Under the Rock