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Care Providers & Care Coordination
The Medical Home Hits the RUC
Today’s post (#2 in a series) tackles several questions:
What is the American Medical Association/Specialty Society RVS Update Committee (RUC)?
What is the RUC’s role in the Medicare Medical Home Demonstration project?
How are people reacting to RUC recommendations for PCMH reimbursement levels?
What is the American Medical Association/Specialty Society RVS Update Committee (RUC)?
The AMA formed the RUC to act as an expert panel in making recommendations to CMS on the relative values of Current Procedural Terminology (CPT) codes using the Resource Based Relative Value […]
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 […]
21 Surprising Ways Wal-Mart Clinics Will Affect US Healthcare
Jessica Hupp at RN Central writes a thought provoking article titled 20 Surprising Ways Wal-Mart Clinics Will Affect US Healthcare.
#20 is “Decreased Continuity of Care”. I think this one is debatable, and I’ll offer as #21 “Increased Continuity of Care”. Â
Jessica writes:
With traditional doctors, patients have charts and medical records, but at in-store clinics, diagnosis is a one-off deal. Problems that could be caught over multiple visits and diagnosis could go unearthed unless the patient works to inform practitioners.
I’m picking up […]
The Medical Home: Advancing, But Still Many Questions
Paul Keckley and colleagues at the Deloitte Center for Health Solutions have released an important contribution to advance the dialog about the medical home (MH). It’s entitled The Medical Home: Disruptive Innovation for a New Primary Care Model. The report offers a strategic perspective on the potential for the MH to address the challenge of chronic care management.
The biggest single contribution of this report is to create a back-of-the-envelope (BOTE) economic model of anticipated costs and benefits from implementing the medical home. […]
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.
The PowerPoint — DM Megatrends 2008
Last week I did the major annual tune-up of my presentation on Disease Management Megatrends for the MCOL Future Care Web Summit.Â
I’m pleased to share a copy of the PowerPoint presentation with you, and I hope you find it useful and provocative. You can view and/or download a copy here (6MB). This version contains 77 slides, which would be about the length I’d use for a 3 hour workshop; you’d see a more compact version for a conference keynote, Board summary, or management […]
Hospital Economics Don’t Reward Chronic Disease Management
My colleague and friend Dr. Jaan Sidorov has recently started a blog — Disease Management Care Blog. Check it out and add it to your RSS feed. Jaan is eminently qualified to write on the topic — he spent 25 years at Geisinger Health System in Pennsylvania as a practicing physician and as an executive, and he just ended a term on the board of DMAA—the Care Continuum Alliance (formerly Disease Management Association of America).
Jaan’s sense of humor and articulateness shine […]
Podcast: The 20 Minute Version of “DM Megatrends”
Over the past week I’ve been doing a major tune-up of my presentation on Disease Management Megatrends for the annual MCOL Future Care Web Summit.Â
More typically, DM Megatrends is 45–90 minute presentation with accompanying PowerPoint slides.
As part of the Web Summit, the good folks at MCOL asked me to do a short podcast on highlights of this presentation. They’re allowing me to share it with you… click here to save or listen to the podcast.
fyi, the DM Megatrends are:
MAGNITUDE: We are just scratching the […]
How the AMA Undermined Chronic Disease Care in America
Over at The Health Care Blog, Brian Klepper has written an excellent article entitled “Bad Medicine: How The AMA Undermined Primary Care in America.”
His essay could just as easily been entitled “How the AMA Undermined Chronic Disease Care in America” — it’s very informative reading.
Disease Management and the Medical Home Model: Competing or Complementary?
I feel like handing out cigars.
My article — “Disease Management and the Medical Home Model: Competing and Complimentary” — has been published in the latest issue of Disease Management and Health Outcomes, a peer reviewed journal.
I’ve arranged with the publisher to make copies available through my website. You can download a copy here.
Why is this an important topic? Here’s the big picture:
Current chronic disease management demonstration/pilot projects in Medicare are showing little evidence of success.
Physicians have woken up to […]