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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 […]
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 […]
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: 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 […]
4 Reasons Why Health Plans Struggle with PHRs
Aetna recently made another big announcement relating to their PHR. While the concept of what they’re doing is very appealing, it strikes me that health plans in general face an uphill battle in getting consumers to adopt and use personal health records (PHRs).
I’ll describe 4 factors behind my thinking:
Lack of Trust
Lack of Access to Clinical Data
Lack of Permission
Lack of Convenience in Consumer Workflow
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. […]
Four Misconceptions About HealthVault and the Emerging Personal Health Information Ecosystem (PHI-Ecosystem)
by Vince Kuraitis and David C. Kibbe, MD MBAÂ
The health care and technology worlds are still trying to figure out what Microsoft’s HealthVault (HV) is all about. We believe that there are a number of misconceptions out there about what HV is and isn’t:
Misconception #1: HealthVault is a personal health record (PHR).
Misconception #2: People don’t trust Microsoft, so they won’t sign up for and use HV.
Misconception #3: Patients don’t understand PHRs, don’t want them, and don’t know what they’d do with them. […]
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 […]