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Care Providers & Care Coordination
What’s the Best Way to Get Hospitals Involved in Care Coordination?
Pay them to do it, take money away when they don’t — make hospitals accountable for their role in avoiding unnecessary readmissions.
Mark E. Miller, Ph.D., Executive Director, Medicare Payment Advisory Commission testified recently in front of the U.S. Senate Committee on Finance. He opened his remarks by stating:
The health care delivery system we see today is not a true system: care coordination is rare, specialist care is favored over primary care, quality of care is often poor, and costs are high […]
Megatrend Spotting: Collaborative Care Management Networks
“Why can’t we all just get along?” Rodney King
The Megatrend: Collaborative Care Management Networks (CCMNs)
It’s been quite a while since I spotted a new Disease Management Megatrend, but here’s one that’s long overdue:
Collaborative Care Management Networks will be necessary to achieve optimal care coordination.
The trend in a nutshell:  payers (and others) are recognizing that optimal care coordination will require collaboration among health care stakeholders. This CANNOT be achieved with yesterday’s proprietary IT and business models.
CCMNs will share many — perhaps all — […]
Details “Emerge” on the Medicare Medical Home Demonstration
Where would one expect to find CMS’ latest thinking on the upcoming Medicare Medical Home Demonstration project? The obvious answer would be “on the Official CMS MMHD home page ”, but you’d be wrong.
CMS has issued a Medicare Medical Home Demonstration Payment Contractor RFP available on the Federal Business Opportunities website. Thanks to the Google Alert service for digging this out.
For the casual reader, the details of the MMHD are taking shape nicely. CMS and its advisors have obviously […]
Doctors Bat A Thousand in Year Two of PGP Medicare Demo
CMS announced today that all 10 participating groups in the Physician Group Practice (PGP) demonstration achieved quality targets, and that the groups are sharing $16.7 million in incentive payments. The program rewards providers for improved outcomes delivered to Medicare patients with congestive heart failure, coronary artery disease, and diabetes.
This goes a long way in explaining Medicare’s seeming lack of enthusiasm for past or future disease management demos with DM companies and/or health plans.
Congratulations doctors!
UPDATE: The doctors might have batted […]
Medical Home PowerPoint and Latest Perspectives
Last week my esteemed colleague Dr. Jaan Sidorov and I conducted a webinar for WRG on Patient Centered Medical Home (PCMH) developments.
The process of updating a PowerPoint forces one to collect one’s thoughts, and I’m glad to share with you the PowerPoint slides along with a few highlights about the evolution of the PCMH. The highlights:
Medical Home Webinar
On behalf of World Research Group, Dr. Jaan Sidorov and I will be conducting a webinar —
Patient-Centered Medical Home Model: Overview and Update.
The webinar takes place next Monday, July 28 at 12 Eastern. Click here for details. Hope you can join us.
AHIP “Adopts” Medical Home Principles: Huh?
On the surface, you might think that a press release issued by America’s Health Insurance Plans (AHIP) adopting principles for a patient centered medical home (PCMH) would advance the cause.
But, look further…
The principles endorsed by AHIP only vaguely resemble the Joint Principles of the PCMH endorsed by 4 major primary care physician groups . These groups represent over 300,000 physicians. (See below for a summary listings of AHIP and physicians’ principles supporting the PCMH).
Why?
Why didn’t AHIP didn’t just endorse the […]
Cerner Disses Google Health. Surprised?
Vince Kuraitis and David C. Kibbe, MD, MBA
We’re not.
From the Kansas City Business Journal :
Google Inc. has approached Cerner Corp. about a partnership, but Cerner officials don’t sound eager to entangle themselves with the Web-search Goliath.
That’s because […]
Extra: Will $87 Per Hour Rescue Primary Care?
Since the AMA has issued some “real” numbers relating to the RUC’s recommendations for valuing the Patient Centered Medical Home (PCMH), I’ve added a fourth part to this series.
The June 2 issue of American Medical News provides payment scenarios for a medical home:
The Medical Home: Pull the RUC Out
This third and final post in the series addresses questions about the future of the Patient Centered Medical Home (PCHM):
What’s problematic about using the RUC methodology with the PCMH?
What’s the optimal level for a PCMH care management fee?
Should primary care leaders pull the RUC out? How?
What’s Problematic About Using the RUC Methodology with the PCMH?
There are at least two reasons for not having the RUC methodology seen anywhere in the same county country as the PCMH. First, the RUC methodology doesn’t […]