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Medicare
An Open Letter to the Obama Health Team on Health IT Spending
By David C. Kibbe, MD MBA and Brian Klepper, PhD
It seems likely that the Obama administration and Congress will spend a significant amount on health IT by attaching it as a first-order priority to the fiscal stimulus package. We take the President-elect at his word when he recently said:
"…we must also ensure that our hospitals are connected to each other through the Internet. That is why the economic recovery plan I’m proposing will help […]
Disruption in the Neighborhood? The PCs Build the Medical Home.
There’s a new house being built in the vacant lot across the street. It’s the medical home, and it is going to be occupied by several primary care physician families (PCs).
From what’s been said, the PCs are nice folks and will make good neighbors. They’re friendly, many are Episcopalian, they like white picket fences, and they have barbeques on Sunday afternoons. The neighborhood they’re coming from is not as well off nor as pristine — they’re said to be suffering from […]
Finally! CMS Provides a Flood of Details About the Medicare Medical Home Demo
I’ve been critical in the past when CMS has been silent in explaining their thinking, so I’ll start this post by congratulating CMS on sharing a flood of details about the upcoming Medicare Medical Home Demonstration project.
An email from CMS arrived in my inbox this morning at 2 am. That email notified me that they have updated the MMHD homepage . A quick click lead me to 8 new documents containing 155 pages of newly available details on the MMHD.
If you have time to read […]
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 […]
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:
The Day the Tide Started Shifting Against Greedy Healthcare
Mark the date — July 9, 2008.
Bob Laszewski describes it eloquently in his blog posting: Senate Votes 69-30 To Rescind Medicare Physician Fee Cuts and Cut Medicare Advantage to Pay For It .
Is healthcare more like schools, fire departments, and roads or is it more like TV sets, shampoo, and movies?
I do think of myself as a strong free market advocate. But, I’ve learned about how isolated, deficient, and expensive the U.S. approach to healthcare is compared to virtually every […]
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 […]
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 […]