Industry News
CMMI launches care coordination demonstration project
The Department of Health and Human Services has unveiled the Comprehensive Primary Care Initiative, a new Center for Medicare and Medicaid Innovation program. Medicare will work with commercial and state health plans to increase payments to primary care doctors who adopt a coordinated care model. The initiative will launch next year as a four-year demonstration project. Participating providers will receive, on average, an extra $20 per patient per month. Providers in HHS-supported ACOs are ineligible. Interested payers must submit a letter of intent by Nov. 15. (Medscape Medical News; California Healthline)
New NCQA program to measure patient satisfaction in medical homes
NCQA has launched the Distinction in Patient Experience Reporting program, which captures results from a new survey measuring patient and family satisfaction with NCQA medical homes' practices, Modern Healthcare reports. NCQA solicited public comments earlier year and the organization worked with the Agency for Healthcare Research and Quality's CAHPS Consortium to develop a medical home version of a Consumer Assessment of Healthcare Providers and Systems survey. (Modern Healthcare; NCQA description)
HRSA provides more funding for community health medical homes
The Health Resources and Services Administration recently provided $32 million to 904 community health centers as part of an initiative to enhance the quality and coordination of care through patient centered medical homes. Each grantee received $35,000, which will provide upfront assistance to help health centers achieve patient centered medical home recognition. Activities will include care planning, support for team-based models of service delivery and system upgrades. (Healthcare IT News; press release)
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Providers & Suppliers
Seasoned vets more likely than youngsters to adopt EHRs
Conventional wisdom says younger physicians are more likely to adopt EHR functionality. However, research published in the Journal of the American Medical Informatics Association indicates older physicians who are clinically busier and see more complex patients are more likely to use novel EHR functionality. In a press release, lead author Jeffrey Linder, MD, MPH, said, "Avoiding assumptions about who will use new functionality will be important in ensuring an increase in the use of these new functionalities and will contribute to the quality gains promised by the use of EHRs." (JAMIA abstract ; press release)
Standardization has its dark side, study finds
Standardization has an unintended consequence called "de-skilling," according to a post on KevinMD. A study published in Health Care Management Review looked at this issue vis-à-vis EHRs: Most primary care physicians reported they (or a specialist) sometimes cut and paste the same language and statements across different patient records. Some physicians didn't tailor EHR templates to the needs of the specific patient. Thus, there was less information to make informed decisions about diagnosis and treatment. (KevinMD; Health Care Management Review)
ACEP chapter sues over state's attempt to limit ED visits
The state chapter of the American College of Emergency Physicians has sued to halt implementation of a new policy under which Washington's Medicaid would pay for only three yearly nonemergency visits to the emergency department, Modern Physician reports. The group claims Washington State Health Care Authority failed to collaborate with the state hospital and medical associations to identify conditions requiring emergency treatment and says that the policy's "uncovered" diagnostic codes includes codes for conditions that dorequire emergency treatment. (Modern Physician; the lawsuit)
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Transformation in Practice
UnitedHealthcare sees health IT benefits in PCMH pilot
UnitedHealthcare is seeing reduced hospital and emergency room use because payers and providers in the company's medical home pilots are sharing data through health information exchange. HIE is seen as a way to improve care coordination and care management, but it can also decrease discretionary or unnecessary costs, according to Sam Ho, MD, UnitedHealthcare's EVP and CMO. With appropriate data, "medical necessity determinations can be made closer to real time and obviate the need for unnecessary diagnostic settings and unnecessary treatment referrals," he said in an eHealth Initiative-sponsored presentation. (Healthcare IT News)
True patient engagement must go beyond buzzwords
Patient-centeredness and patient engagement become nothing but buzzwords if patients' choices and values are discounted, Molly Mettler, senior VP for Healthwise, says in an interview on the Prepared Patient Forum. Even "evidence-based" is overused-and tends to "displace the importance of patient autonomy," she says. Mettler advocates for transformation of the health care consumer's role from passive recipient to strong, active and involved participant. She also identifies three significant personal events when individuals are ready to be engaged: having a baby; at the time of a diagnosis of serious illness; and end-of-life planning. (Prepared Patient Forum)
BSBSNC to provide physicians with health IT
Blue Cross and Blue Shield of North Carolina plans to spend $15 million to provide up to 750 state physicians with state-of-the-art electronic medical records. According to BCBSNC, the physicians, who work for free clinics or in independent small practices, will have technology they may not otherwise be able to afford. BCBSNC will pay 85 percent of the cost for around 600 physicians, and all costs for 150 in 39 free clinics, with the goal of helping them meet Meaningful Use and medical home requirements. (Health Data Management)
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The Expanding PCMH: News and Updates
The Pediatric and Adolescent Health Center in Pasadena, Texas, held its official open house last month. The center, staffed by Baylor physicians, will be a pediatric medical home and offer a range of care services, including pulmonary; developmental and high risk; special needs; rheumatology; gastrointestinal; psychiatry, psychology and behavioral health; and adolescent weight management. (Your Houston News)
Irongate Family practice of Glens Falls, N.Y. has been designated by NCQA a Level 3 patient centered medical home. (Post-Star)
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The Centers for Medicare and Medicaid Services recently announced four bundled payment models for its Care Improvement Initiative. Health Data Management provides a slideshow that breaks down the models. (Health Data Management)
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MarketVoices...quotes worth reading
"Once the patient is well-informed and understands her options, patient autonomy in treatment needs to be honored within legal and ethical limits. The grail in medical shared decision making is making it possible to combine evidence-based options with the patient's personal preferences and values."
-- Molly Mettler, senior vice president for Healthwise, on the Prepared Patient Forum
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PCPCC Update
Link to current events, reports and news from the Patient-Centered Primary Care Collaborative (PCPCC)
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