What negative impact will this legislation have on long-term care, and specifically Assisted Living and CCRCs? Thank you.

Scott Geller, MS

I think BCBS Michigan has a sensible approach to reimbursement of PCMH; from public domain info – a 10% increase in E&M fees for primary care practices they designate as PCMH.

I’ll be interested to see if CMS emulate this structure.

So, lets get to work!

http://boutiqueMed.com
http://ACOalliance.com

Thank you!

Given that your readers are likely interested in how they may participate in some of the demos and projects, I thought I would suggest a way of sorting through the opportunities.

Step 1: What types of entities are eligible project participants? If you aren’t eligible, go to step 2.

Step 2: Will the project be administered in a manner that provides opportunities for subcontractors? If so, go to step 3.

Step 3: Determine whether your organization is suited to be a subcontractor to an eligible entity.

Here’s an example using Section 4206:

Step 1 – Eligibility. The recipient of funds under Sec. 4206 must be a “community health center” funded under 42 U.S.C. 245b, which is found under “health center” at 42 U.S.C. 254b. To qualify, you must fit within one of the trendy categories of “health services” listed there, or certain exceptions. If you don’t qualify, go to Step 2.

Step 2 – Administration. The Secretary of HHS will dole out grants for 4206 directly to the “community health center” that is “funded under 42 U.S.C. 245b.” The health center will likely have ties to state government because one of the two factors for determining criteria is comments received from state officials. Sec. 254(b)(3)(B). Under open government protocols followed these days by most states, you will be able to find out which wellness programs your state is endorsing doing by looking at the state department of health web site.

Step 3 – Subcontracting Options. Section 4206 is a new program, so there aren’t any established entities with subcontracting processes to use as an example. But if you look at the pattern established with HITECH Act funds in California, for example, we aer just now getting through the public comment process of its operational plan for ARRA funds earmarked back in February 2009. Consulting firms have been facilitating the process and design of the solutions, and will likely continue to do so.

You deserve an award for having the patience to put this listing together. On behalf of all the “lurkers” outhere in cyber space – thank you!

David de Bhal