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Search Results: "Medical Home"
Pilots, Demonstrations & Innovation in the PPACA Healthcare Reform Legislation
Here’s a bit of trivia that will make you the hit of the next cocktail party you attend. How many times are the words “demonstration” and “pilot” mentioned in the newly passed Federal healthcare reform legislation — the Patient Protection and Affordable Care Act (PPACA)?
Answer:
“demonstration” — 312 mentions
“pilot” — 80 mentions
This weekend I’ve been trying to wrap my head around the question “Just what are these demos and pilots in the PPACA all about?” I have been boggled by the sheer number […]
The Real Secret Sauce of Medicare’s Participation in Regional Collaboratives — Network Effects
Last week I asked whether Medicare’s Biggest Change in 40 Years is on the horizon. That post described and discussed implications of Medicare’s new direction for the medical home — the shelving of Medicare Medical Home Demonstration (MMHD) and the refocusing on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI).
In that post I touched briefly on the potential for MAPCI to create effective networks at multiple levels — contracting networks, health IT networks, social and collaborative care networks. I’d like to expand […]
Medicare’s Biggest Change in 40 Years on the Horizon?
Earlier this week CMS issued a typically cryptic Announcement indicating that they were shelving the Medicare Medical Home Demonstration (MMHD) and instead would focus on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI). My blog post from Tuesday provides details and asks the question “What does all this mean?”
Today’s blog post will tackle:
Medicare’s biggest change in 40 years?
The rise of MAPCI
The fall of MMHD
Implications/discussion
Medicare’s Biggest Change in 40 Years?
Senator Grassley: You’re on Track About EMR Problems, But Here Are Some More Questions to Ask
An article in today’s Washington Post links to a letter written by Senator Charles E. Grassley.
The letter is directed at 10 EMR (electronic medical record) vendors, and asks very pointed questions about whether the vendors have been negligent in not addressing patient safety issues in their technologies.
Senator Grassley, you have the scent and you’re on the trail. There are several other questions you should be asking these vendors:
The Big Idea in Understanding “Accountable Care Organizations”
Here’s the big idea: accountable care organizations (ACOs) are about creating accountability.
ACOs of various types are being proposed in national health reform legislation. For all you ever wanted to know about ACOs, read How to Create Accountable Care Organizations from the Center for Healthcare Quality and Payment Reform.   I spent an hour and a half poring over the details of this excellent report written by Harold Miller.
My mistaken impression has been to focus on the organizational form of ACOs, rather than their objectives. Organizational form is relevant […]
“Meaningful Use” Criteria as a Unifying Force
by Vince Kuraitis, Steve Adams, and David C. Kibbe MD, MBA
Over the past several years, many diverse initiatives have arisen offering partial solutions to systemic problems in the U.S. health care non-system.Â
We see Meaningful Use Criteria recommended by the HIT Policy Committee as a unifying force for these previously disparate initiatives. These initiatives have included:
Patient Centered Medical Homes (PCMHs)
Regional Health Information Organizations (RHIOs)/Health Information Exchanges (HIEs)
Payer Disease/Care Management Programs
Personal Health Record Platforms — Google Health, Microsoft HealthVault, Dossia, health banks, more to come
State/Regional […]
Time for EHRs to Become Plug-and-Play
by David C. Kibbe MD, MBA
The remarkable report, “Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home,” published in the May/June issue of Annals of Family Medicine, the Nutting Report, makes this point about the state of primary care IT offerings:
Technology needed in a PCMH is not “plug and play.” The hodge-podge of information technology marketed to primary care practices resembles more a pile of jigsaw pieces than components of an integrated and […]
Landmark Report: “The Promise of Care Coordination” in Medicare
Download a copy here . Excerpts from the Executive Summary:
Effective Interventions
Three types of interventions have been demonstrated to be effective in reducing hospitalizations for Medicare beneficiaries with multiple chronic conditions who in general are not cognitively impaired:
Transitional care interventions in which patients are first engaged while in the hospital and then followed intensively over the 4 – 6 weeks after discharge
Self-management education interventions that engage patients for 4 -7 weeks in community-based programs designed to “activate” them in […]
Will HITECH Lead to Innovation? The Continuing Cat/Dog Dialogue
Will the recently passed HITECH legislation — the federal stimulus funding for health IT — encourage innovation? or will it lock in outdated electronic health record (EHR) technology?
It’s a mixed bag — HITECH legislation is both dog-like (innovative) and catlike (protecting incumbents).  I’ll refresh your memory below on more specific definitions of cats and dogs.
Among many other reasons, HITECH is dog-like primarily because it has ended the question of WHETHER the U.S. is really serious about health IT reform. HITECH spells out […]
Spider Webs of Care Coordination Networks
We have learned that coordinating care of patients — particular care of Medicare patients — is complex and time consuming for physicians.
A breakthrough study quantifies just how complex and challenging care coordination really is.  The study is reported in the February 17 issue of Annals of Internal Medicine and is entitled Primary Care Physicians’ Links to Other Physicians Through Medicare Patients: The Scope of Care Coordination :
We found that in a single year for just fee-for-service Medicare patients, the typical primary care physician needs […]