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 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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