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primary care

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 […]

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 […]

21 Surprising Ways Wal-Mart Clinics Will Affect US Healthcare

Jessica Hupp at RN Central writes a thought provoking article titled 20 Surprising Ways Wal-Mart Clinics Will Affect US Healthcare.

#20 is “Decreased Continuity of Care”.  I think this one is debatable, and I’ll offer as #21 “Increased Continuity of Care”.  

Jessica writes:

With traditional doctors, patients have charts and medical records, but at in-store clinics, diagnosis is a one-off deal. Problems that could be caught over multiple visits and diagnosis could go unearthed unless the patient works to inform practitioners.

I’m picking up […]

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.

 

How the AMA Undermined Chronic Disease Care in America

Over at The Health Care Blog, Brian Klepper has written an excellent article entitled “Bad Medicine: How The AMA Undermined Primary Care in America.”

His essay could just as easily been entitled “How the AMA Undermined Chronic Disease Care in America” — it’s very informative reading.

POE Award: Linda Magno of CMS Acknowledges the Elephant in the Room with Medicare DM

Just about everybody in the world has been talking about problems that Medicare is having with chronic disease management (DM) demonstration projects…everybody except the folks at Medicare.

Well, that’s finally changing. Today’s POE (plain old English) award is presented to Linda Magno, Director, Medicare Demonstrations at CMS (Centers for Medicare and Medicaid Services).

Here are a couple of slides from Ms. Magno’s presentation at the Patient Centered Primary Care Collaborative Summit on November 7:

Four Misconceptions About HealthVault and the Emerging Personal Health Information Ecosystem (PHI-Ecosystem)

by Vince Kuraitis and David C. Kibbe, MD MBA 

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.  […]

Health 2.0 Deserves Careful Watching

by David C. Kibbe, MD MBA

Dear Colleagues:

Thursday I attended a wonderful one day conference, entitled “Health 2.0 — User Generated Health Care.” One of the most interesting events of 2007. Held in San Francisco. I had a chance to talk with Adam Bosworth and Missy Krasner of Google, with Peter Neuport of Microsoft, and with David Brailer, among many others. It was particularly good to see Drs. Walter Lim and Rick Chan, with the Ministry of Health in Singapore, who came […]

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 […]

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