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Medicare Health Support
The Medical Home: Confusion Over Care Management Fees
The honeymoon is over.
Prior to April 29, 2008, reviews of the Patient Centered Medical Home (PCMH) model had been uniformly enthusiastic and positive.
Today the PCMH model is hitting reality — someone’s going to have to bring home money to pay the bills. On April 29 the American Medical Association/Specialty Society RVS Update Committee (RUC) released a  report making recommendations relating to payment levels of care management fees for the PCMH.
This report has stirred cries of confusion and outrage. I’ll elaborate on these cries in the second posting of […]
Healthways Fights an Uphill Battle on Medicare Health Support Phase II
Earlier this week Healthways issued a press release describing their progress in pursuing a Phase II Medicare Health Support (MHS) project.  Read Dr. Jaan Sidorov’s blog commentary for additional background.
In brief, Healthways position is that the Centers for Medicare and Medicaid Services (CMS) is statutorily required to expand into Phase II of MHS if Phase I is “successful”. While I’m very sympathetic with Healthways predicament and their frustration with CMS, I’m not optimistic that their tactics are likely to work.
In making the case, Healthways […]
NYT Provides More “Enlightened Ambiguity” on Medicare Health Support
While not providing anything close to the “final answer”, The New York Times does a good job summarizing the onoging Medicare Health Support (MHS) fracas. To borrow from one of my colleagues, it’s more “enlightened ambiguity” about the ultimate fate of the MHS beached whale.Â
Medicare Finds How Hard It Is to Save Money, The New York Times; April 7, 2008
For One Company, Role in Medicare Experiment Has Hurt Stock, The New York Times; April 7, 2008
The Medicare Health Support Saga: Opacity in Government Going Strong
 Vince Kuraitis and Thomas Wilson, PhD, DrPH
“If you aren’t confused you don’t know what’s going on.”
Jack Welch, former CEO, General Electric
       Â
Thanks to the continuing opacity of the Centers for Medicare and Medicaid Serices (CMS), we remain confused about the future of Medicare Health Support (MHS).
It’s been over a month since we last commented on MHS. What’s MHS?  It’s JUST the Federal Government’s most significant and visible effort to deal with one of the American health system’s biggest challenges — managing care for patients with […]
Podcast Part Deux: Medicare Health Support in Jeopardy
Here’s the link to Part II of the podcast in which Tom Wilson and I are interviewed by Les Masterson of HealthLeaders Media. If you want to start at the beginning, Part I is available here.
Medicare Health Support: “Do not go gentle into that good night”
Vince Kuraitis and Thomas Wilson, PhD, DrPH
“Do not go gentle into that good night.
Rage, rage against the dying of the light”
Dylan Thomas
  Â
Despite CMS’ recent cocktail hour pronouncement that Medicare Health Support (MHS) is on its last legs, many are fighting to prolong its life.
Recent Developments
DMAA is working with Sen. John Kerry to introduce legislation mandating the continuation of Medicare Health Support (MHS). Dr. Jaan Sidorov’s Disease Management Care Blog reprints the full announcement from the February 12 issue of […]
HealthSpring “Gets” Physician Engagement.
I’ve written a lot recently about Medicare Health Support (MHS). We are learning a lot from MHS about what DOESN’T work with the frail, elderly Medicare population.
But, what DOES work?
One key lesson emerging from MHS is the need to integrate and engage physicians and other local care providers…easier said than done.
Guest Post: The CMS Announcement Of Medicare Health Support Program Cancellation — What It Means For Buyers
by Al Lewis, JD
Add the Centers for Medicare and Medicaid Services (CMS) to the growing list of people and organizations who cannot find financial savings through disease management. Weeks after “lowering the bar” on MHS program savings requirements to 0% from 5%, CMS cancelled the program altogether due to the unlikelihood that the much-reduced threshold for savings would be achieved in the remaining months of the three-year measurement period.
Yet even as CMS’ conclusion mirrors that of the Congressional Budget Office, and the RAND Corporation, other organizations and […]
Insufficient Evidence to End Medicare Health Support
Thomas Wilson, PhD, DrPH and Vince Kuraitis
Last Tuesday during the cocktail hour, CMS issued documents portending the end of the Medicare Health Support (MHS) project. Â
We initially used the word “bizarre” to describe the announcement from CMS’ staff. After further thought, “reckless” and/or “insubordinate” strike closer to home.
First, let’s have the head-honcho at CMS instruct us on how things should be done. In September 2007 Kerry Weems, the new CMS Administrator, declared that “cocktail hour press releases” from his agency […]
$389 M of Healthways’ Market Value Vaporizes After CMS Announcement. What Happened?
Healthways stock price declined today by $10.52 (15.9%) after CMS “announcement” about ending Medicare Health Support (MHS) Phase 1. This equates to a loss of $389 million in market capitalization…poof! Gone. Healthways is one of the remaining five participants in the MHS program.
Without pointing fingers, it’s obvious that investors were surprised by the news.  What happened?
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