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Medicare
CMS Shelves Medicare Medical Home Demonstration
I just received an email from CMSÂ announcing the latest official word on the Medicare Medical Home Demonstration (MMHD):
10/26/2009 – In Washington, the efforts to reform health care and health insurance include proposed legislative language that would have an impact on the Medicare Medical Home Demonstration as described in section 204 of the Tax Relief and Health Care Act of 2006 and amended by section 133 of the Medicare Improvements for Patients and Providers Act of 2008. Specifically, section 1302 of […]
Lifemasters Bankruptcy: Will CMS Earn Reputation as a Good Business Partner or Thug?
In my post from Monday on LifeMasters seeking Chapter 11, I dropped a BTW comment.
The part that’s puzzling to me is the statement that LifeMasters owes $125 M to CMS. That’s hard to figure…the company only participated in MHS for a few months, and to my knowledge MHS is the only Medicare demo that required guaranteed savings (i.e., payback if targets aren’t hit). Â
I really have to stretch my imagination to compute how CMS ran the tab to such an astronomical number. It raises […]
Medicare Health Support (MHS) Claims Another Victim: LifeMasters Files for Chapter 11
Updated 6:10 pm, September 14, 2009
One bad deal can ruin your day.
Today, LifeMasters filed for Chapter 11 bankruptcy protection. According to its press release:
“The Chapter 11 filing is the most efficient path for the company to restructure liabilities that are a result of Demonstration Projects previously performed under contracts with the Centers for Medicare and Medicaid Services (CMS), ” said George D. Pillari, President of LifeMasters. Mr. Pillari, named President of LifeMasters today, is a Managing Director of Alvarez & Marsal […]
CCHIT’s Latest Gambit
by Glen Laffel MD, PhD
Many of us have enjoyed a few good minutes of fun having our fortunes told by soothsayers who claim they can predict our future based on patterns of tea leaves in a cup or the playing cards we’ve pulled from a deck.
We pay a few dollars for the entertainment and if the fortune teller is skilled, we are temporarily impressed by his “insight.” But once we leave the carnival, we come back […]
Part II — The Medicare Medical Home Demonstration: Crawling Out From Under the Rock
In Part I of my guest post on The Collaborative Forum blog, I wrote that the Medicare Medical Home Demo is in BIG Trouble. Here’s a recap:
Political reality dictates that the MMHD must save costs.
As currently structured, the MMHD cannot achieve cost savings
In any given year, only a small percentage of patients account for the vast majority of costs
Lessons from previous Medicare disease/care management demonstrations has shown that effective care coordination interventions must be targeted at this population
Medicare has structured the […]
HIT Policy Committee Recommends “Minimum” Certification of EHRs
At last Friday’s meeting, the HIT Policy Committee adopted the recommendations of the Certification and Adoption Workgroup.
Between the initial recommendations in July and the adopted recommendations in August, one critical word was added to the definition of “certification”. That one word is “minimum” — and this one word expresses the correct approach and philosophy for the government’s role in the certification process for EHRs.
In this post I’ll address why a “minimum” approach toward certification makes […]
Medicare Medical Home Demo (MMHD) is in BIG Trouble
Between the time the MMHD was authorized in 2006 and now, we’ve learned a lot about what works and what doesn’t work in Medicare care coordination programs. The MMHD is between a rock and a hard place — conflicted by two “must achieve” objectives that are diametrically opposed:
As a political matter, the MMHD must save money
As currently structured, the MMHD cannot save money
Please read my guest post
The Medicare Medical Home Demonstration (MMHD): Between a Rock and a Hard Place
over at […]
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 […]
Hope for Primary Care … from a Payer? A White Paper on the Collaborative Payer Model
by Tom Doerr, MD and Randy Bak, MD, JD
What if the health care payer were re-imagined as a service to the primary care doctor – supplying the tools, information and funding primary care physicians needed to meet the call to reform health delivery?
The structure of physician payment is considered one of the most problematic aspects of our health care system. Driven by volume instead of coordinated, proactive care and favoring procedures over cognitive work, the payment system has driven primary […]
Wait and See: What’s Unclear or To-Be-Determined (TBD) About HITECH.
Sometimes laws are passed and the statute itself represents 95% of the work — there aren’t many details to figure out or loose ends to tidy up.
That isn’t the case with HITECH. The HITECH statute is just the beginning.
Whether you’re a cat or a dog, you’ll have hopes and fears about aspects of HITECH that are unclear or yet to-be-determined (TBD).
These include: