Industry News
ACO rule one step closer to becoming final
The Centers for Medicare and Medicaid Services has sent a Shared Savings/Accountable Care Organization final rule to the Office of Management and Budget for review, Health Data Management reports. OMB review is one of the last steps before a rule is published in the Federal Register. Without a final rule by mid-October, it will be difficult for CMS to meet its Jan. 1 deadline for launching ACOs. (Health Data Management; Kaiser Health News)
Patients may one day be able to give consent electronically
The Office of the National Coordinator has awarded a $1.24 million contract to APP Design to develop and evaluate ways to electronically obtain patients' consent to share personal health data, Government Health IT reports. It quotes the ONC's background material regarding the project's importance: "Informed patient choice is one way to ensure a trust relationship with patients for the success of electronic health information exchange." The project launches later this month. (Government Health IT; ONC background information)
IOM report offers criteria for ACA essential benefits package
A new Institute of Medicine report provides recommendations to Health and Human Services for developing a package of essential benefits for qualified health plans under the Affordable Care Act. As Modern Healthcare describes it, the essence is both simple and profoundly complex: "Find what works already and improve on it over time." The IOM says HHS should measure potential services and products against a set of criteria (e.g., medical effectiveness, safety, and relative value) and determine whether the package protects the most vulnerable, promotes effective services, and addresses medical concerns of greatest public importance. (Modern Healthcare; AHA News Now; IOM Report)
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Providers & Suppliers
Connecticut patient advocates oppose enhanced fee-for-service
Patient advocates are raising concerns about Connecticut Dept. of Social Services' approach to paying for the medical home. Mark Schaefer, the DSS director of medical care administration, favors a system that builds on the fee-for-service model, raising fees paid to health care providers who serve as medical homes, the Connecticut Mirror reports. They would be eligible for additional payments if they met certain performance targets. But patient advocates argue that enhanced fee-for-service encourages overtreatment and over-utilization of services. (Connecticut Mirror)
Health IT will never replace human diagnostic skills, providers say
According to a QuantiaMD study, decision support and artificial intelligence can help prevent diagnostic errors, but will never replace the physician's role in diagnosis. Seventy-five percent of respondents viewed clinical decision support and artificial intelligence tools as crucial in curbing errors, but 56 percent said such technologies will never eliminate the doctor's role in patient diagnosis. The survey of 6,400 providers also found 47 percent of respondents face diagnostic errors at least once a month, Healthcare IT News reports. (Healthcare IT News)
Maryland's PCMH program has distributed $3 million
Maryland's recently launched patient centered medical home program has given an average of $56,000 to 54 participating primary care physician offices across the state, the Baltimore Business Journal reports. Overall, the program has distributed about $3 million in its first months of operation: $2.1 million from commercial insurers and another $900,000 from Maryland Medicaid. The larger the practice--and the sicker its mix of patients--the more money received. (Baltimore Business Journal)
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Transformation in Practice
Oregon governor promotes coordinated care organizations
Oregon Gov. John Kitzhaber plans to place Medicaid recipients into "coordinated care organizations" that would oversee patients' physical, mental and dental health, according to Capsules, the Kaiser Health News blog. The state would pay each team of CCOs a set fee, and they would be rewarded for keeping patients healthy and out of the hospital. CCOs would hire community health workers to address non-medical issues that can affect health, such as transportation and housing. (Kaiser Health News Capsules)
SAMHSA funds will help integrate primary, behavioral health care
The Substance Abuse and Mental Health Services Administration will will distribute one-year grants of approximately $200,000 each to 47 community health centers working to integrate primary care and behavioral health services. "By providing effective routine health promotion activities, primary care screening, monitoring, treatment and care management, we can go a long way to combating preventable disease and improving the health and well being of many Americans," says SAMHSA Administrator Pamela Hyde. (InformationWeek; press release)
N.Y. incentives help community health center promote primary care
In the last year, the Open Door Family Medical Centers in Ossining, N.Y., added 1,867 new Medicaid patients, a 14 percent increase. According to Lindsay Farrell, CEO and president, that helps meet the goal of connecting more individuals with primary care physicians to prevent and manage conditions such as diabetes, obesity and high blood pressure. Through the Patient-Centered Medical Home Incentive Program, the state is providing funds to help Open Door and similar centers meet that goal. Open Door received $14.8 million in Medicaid revenue in 2010, a 14 percent increase from 2009. (The Journal News)
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The Expanding PCMH: News and Updates
Dr. Masoud Ahdieh was the first pediatrician to open a practice in Richmond County, N.C. Now, his practice, Community Care of the Sandhills, is the first in the county to be awarded Level 3 NCQA recognition from the NCQA. (Richmond County Daily Journal)
Sixteen more Aurora Health Care sites have achieved NCQA Level 3 recognition. According to Aurora, it was the first health system in Wisconsin to have a clinic receive this designation and now 51 have earned this status. (Wisconsin Health News)
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NPR's Morning Edition interviews patients and physicians at True North, a nonprofit health care clinic in Falmouth, Maine that allows patients to barter work for health care. (NPR)
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MarketVoices...quotes worth reading
"The problems with Medicaid are no different than the problems with commercial insurance and Medicare. It's the problem with the way the health care system is organized and delivered in the United States."
-- Lindsay Farrell, CEO and president of Open Door Family Medical Centers, in The Journal News
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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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