Industry News
AMA committee asks CMS to pay for care coordination tasks
The AMA/Specialty Society RVS Update Committee (RUC), which recommends physician pay scales to Medicare's fee-for-service program, has asked CMS to reimburse physicians for coordinating care for their chronically ill patients, Medscape Medical News reports. In a letter to CMS Administrator Donald Berwick, the RUC recommended CMS pay for phone calls, counseling sessions and other care coordination services. (Medscape Medical News; the letter)
HHS seeks input on benefits to be offered by health insurance exchanges
The Department of Health and Human Services will hold listening sessions to elicit public opinion regarding the essential health benefits package to be offered by health insurance exchanges, HealthLeaders Media reports. The package's pillars are medical effectiveness, safety and their relative value compared with alternatives, according to a recent Institute of Medicine recently report. The IOM left the details to HHS. (HealthLeaders Media)
US again fares poorly on Commonwealth scorecard
The third national scorecard report from the Commonwealth Fund finds that the US as a whole failed to improve compared to best performers in the country--and to other nations. (The data comes from before the Affordable Care Act was enacted.) The US does especially poorly on measures of health system efficiency (e.g., duplicative services, hospital readmissions, use of electronic information systems). The report also finds significant erosion in access and affordability.
(National Scorecard on U.S. Health System Performance, 2011)
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Providers & Suppliers
Survey: Meaningful Use a higher priority than EHR security
A Healthcare IT News survey funded by Oracle and Deloitte revealed that although 80 percent of responding IT workers consider Meaningful Use a top priority, only 38 percent said they have moved to an enterprise-wide implementation of secure EHR systems. The survey results confirm what Oracle and Deloitte are seeing in the marketplace, attendees were told at the recent Oracle OpenWorld Conference. This could be driven in part by insufficient resources and overlapping requirements, according to Russell Jones, partner at Deloitte. (Healthcare IT News)
Changes in store of Stage 2 Meaningful Use?
Will Stage 2 Meaningful Use be different in each of its two years? Perhaps, according to Health Data Management, citing Dan Rode of the American Health Information Management Association. Stage 2 starts in October 2012 for hospitals and January 2013 for eligible professionals--just as providers will be struggling to meet the ICD-10 deadline. He suggests the following scenario: Stage 2 starts in January 2013 with minor changes from Stage 1, such as raising Meaningful Use quality measures a bit. Any major changes or new requirements would wait until 2014. (Health Data Management)
ACP: MedPAC SGR proposal could impair access to care
In a letter to MedPAC, the American College of Physicians says it appreciates MedPAC's proposal to eliminate the sustainable growth rate (SGR) with the intent of protecting access to primary care for Medicare beneficiaries, but warns it will not adequately protect and ensure primary care access, and will reduce access to other physician services. The proposal, ACP says, runs counter to the goal of developing new value-aligned delivery and payment models; it could make it more difficult for subspecialists to invest in new models such as the medical home. (Eureka Alert; the letter)
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Transformation in Practice
Pittsburgh pilot ready to fly
Preferred Primary Care Physicians, a Pittsburgh-area 32-doctor group, is piloting an advanced medical home model with assistance from HealthAmerica, a subsidiary of Coventry Health Care. The goal is to provide more coordinated and patient-centered primary care and improved communications among patients, their physicians and their care team. "This arrangement is unique in that patients and families will participate in quality improvement activities at the practice level," said Dr. Robert Mirsky, chief medical officer for HealthAmerica, which will, among other tasks, track quality measures. (FierceHealthIT)
Pediatric medical homes less costly for special needs children
Parents of children with special health care needs pay less in out-of-pocket expenses when the children are cared for in a medical home setting, according to a report published online October 17 in Pediatrics. Researchers analyzed 2005-2006 data from the National Survey of Children with Special Health Care Needs, including information about 31,808 children; 73 percent had private insurance, 27 percent had public insurance. The study's results indicated the care coordination component of the medical home helped to lower out-of-pocket medical costs per $1,000 of household income. (Medscape; Pediatrics)
Grants, volunteer docs to help build charity care medical home
Cincinnati-area primary care doctors will pledge to become the medical home for 12 patients yearly under Project Access, a charity-care program starting in January. Specialists would provide free care to 24 patients annually. The Academy of Medicine of Cincinnati already has signed up about 200 doctors. Grant money will help fund a care navigator and social worker to coordinate referrals for volunteer care. Each patient also will be assigned someone who will help with missed appointments, transportation and language barriers. (Cincinnati Enquirer)
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This Patient-Centered Primary Care Collaborative webinar shows how Affinity Medical Group in Wisconsin launched its first medical home pilot site in 2009, then successfully rolled it out to 26 locations. It offers operational, financial and clinical perspectives. (PCPCC)
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MarketVoices...quotes worth reading
"Great effort and expense has already been undertaken by many practices and organizations across our nation to work toward practice improvement through [the] patient centered medical home. We believe that if CMS builds upon ... these efforts, and the work that the RUC [The AMA/Specialty Society RVS Update Committee] has already done in valuing the Patient Centered Medical Home, the outcome will lead to greater acceptance and success of this critical project."
-RUC letter to CMS Administrator Donald Berwick
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