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 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 the series--Medicare Medical Home Demo Challenges

  1. Medicare Medical Home Demo (MMHD) is in BIG Trouble
  2. Part II — The Medicare Medical Home Demonstration: Crawling Out From Under the Rock

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