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Medicare
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 […]
Healthways Fights an Uphill Battle on Medicare Health Support Phase II
Earlier this week Healthways issued a press release describing their progress in pursuing a Phase II Medicare Health Support (MHS) project.  Read Dr. Jaan Sidorov’s blog commentary for additional background.
In brief, Healthways position is that the Centers for Medicare and Medicaid Services (CMS) is statutorily required to expand into Phase II of MHS if Phase I is “successful”. While I’m very sympathetic with Healthways predicament and their frustration with CMS, I’m not optimistic that their tactics are likely to work.
In making the case, Healthways […]
NYT Provides More “Enlightened Ambiguity” on Medicare Health Support
While not providing anything close to the “final answer”, The New York Times does a good job summarizing the onoging Medicare Health Support (MHS) fracas. To borrow from one of my colleagues, it’s more “enlightened ambiguity” about the ultimate fate of the MHS beached whale.Â
Medicare Finds How Hard It Is to Save Money, The New York Times; April 7, 2008
For One Company, Role in Medicare Experiment Has Hurt Stock, The New York Times; April 7, 2008
The Medicare Health Support Saga: Opacity in Government Going Strong
 Vince Kuraitis and Thomas Wilson, PhD, DrPH
“If you aren’t confused you don’t know what’s going on.”
Jack Welch, former CEO, General Electric
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Thanks to the continuing opacity of the Centers for Medicare and Medicaid Serices (CMS), we remain confused about the future of Medicare Health Support (MHS).
It’s been over a month since we last commented on MHS. What’s MHS?  It’s JUST the Federal Government’s most significant and visible effort to deal with one of the American health system’s biggest challenges — managing care for patients with […]
How Will the HMO Stock Meltdown Affect Chronic Disease Management?
About three weeks ago Cain Brothers Investment Bankers released a report that foreshadowed the collapse of HMO stock prices that has occurred over the past few days. The report was entitled: FAREWELL TO A TIME OF PLENTY? Health Plan Strategies for Growth in a More Challenging Market.Â
Here are a few highlights from the report:
Podcast Part Deux: Medicare Health Support in Jeopardy
Here’s the link to Part II of the podcast in which Tom Wilson and I are interviewed by Les Masterson of HealthLeaders Media. If you want to start at the beginning, Part I is available here.
The Wrong Way and the Right Way to Frame PHR Privacy/Confidentiality Issues
 Vince Kuraitis and David C. Kibbe, MD MBAÂ
During the past week two reports were released discussing privacy/confidentiality issues surrounding PHRs. One of these reports did it the wrong way; one did it the right way.
The general public is just learning about Personal Health Records (PHRs). We believe that the appropriate way to frame the dialogue for the public is to acknowledge both the benefits and risks:
Benefits: PHRs (and EHRs) have the potential to save lives, reduce medical errors, improve patient […]
Medicare Health Support: “Do not go gentle into that good night”
Vince Kuraitis and Thomas Wilson, PhD, DrPH
“Do not go gentle into that good night.
Rage, rage against the dying of the light”
Dylan Thomas
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Despite CMS’ recent cocktail hour pronouncement that Medicare Health Support (MHS) is on its last legs, many are fighting to prolong its life.
Recent Developments
DMAA is working with Sen. John Kerry to introduce legislation mandating the continuation of Medicare Health Support (MHS). Dr. Jaan Sidorov’s Disease Management Care Blog reprints the full announcement from the February 12 issue of […]
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.