Industry News
PCPCC releases care coordination publication
The Patient-Centered Primary Care Collaborative has released Core value, community connections: Care coordination in the medical home. It was developed by Health2 Resources on behalf of the PCPCC, with unrestricted support from Phytel and Merck. It includes thought leaders' insights on the theories and tactics behind the definition, role and function of care coordination. A chapter by Commonwealth Fund experts outlines seven key strategies to help health systems effectively measure care coordination as a routine part of medical home activities. (Commonwealth Fund blog; care coordination guide; Disease Management Blog)
CMS releases significantly changed final ACO rule
CMS released its final ACO rule. It includes several concessions to address concerns raised by the draft rule. Providers will now be able to participate in an ACO and share in savings with Medicare without risk of losing money. ACOs will be able to start sharing in the savings earlier. The number of quality measures that ACOs will have to meet to qualify dropped from 65 to 33. The ACOs will be told which Medicare beneficiaries are likely to be part of their system. Groups will be allowed to apply throughout 2012. (Kaiser Health News; final rule; CMS table showing differences between draft and final rule)
California expands access to telehealth services
California Gov. Jerry Brown signed the Telehealth Advancement Act of 2011, loosening requirements about who can provide care using telehealth. It expands eligibility to all licensed health care professionals and makes it easier to provide telehealth through the state's Medicaid program and, under certain circumstances, for patients with private insurance, Modern Healthcare reports. (Modern Healthcare; CTEC press release)
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Providers & Suppliers
Forty percent of primary care practices don't qualify as a PCMH
Almost half of U.S. medical practices and 40 percent of primary care practices fail to qualify as a patient centered medical home under NCQA standards, according to a study published in Health Services Research. The authors found 46.3 percent of all practices lack the infrastructure for an NCQA-defined medical home. Those least likely to attain NCQA recognition are solo and two-partner practices, which are most US practices; the most likely are groups of 11 physicians or more. They conclude "groups will require both substantial assistance and significant retooling" to qualify. (Medscape News Today; Health Services Research abstract)
Speaker: Teamwork is essential to sustainability of the medical home For medical homes to become a larger part of the health care system, participants must be trained in how to work in teams, said Larry Mauksch, M.Ed., of the University of Washington, during the recent Maine Primary Care Association's annual conference. The challenge, he told attendees, is to transform "a bunch of individual functions into a ... team." Time demands in primary care are enormous; "the solution is teamwork." (Health Finance News)
AAFP president: Innovators moving ahead, but many providers need support Glen Stream, MD, newly installed president of the American Academy of Family Practitioners, is encouraged by the medical home's development, he told AAFP News Now. "With most innovations, you see the early adopters--the true innovators--and then the practices that follow just behind. I think we are really in the middle of the bell-shaped curve of recognizing the importance and value of the PCMH and making that transformational effort." However, he stressed the importance of providing resources to support "the bulk of our members, who are just working hard every day to keep their necks above water." (AAFP News Now)
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Transformation in Practice
FQHCs could -- and should -- transform into PCMHs, research suggests
Research published by the Commonwealth Fund examines how changes in the way federally qualified health centers are financed could help transform them into high-performing medical homes. The authors make preliminary recommendations to encourage health centers to serve as medical homes. These include establishing recommended standards for patient- and community-centered medical homes that apply to FQHCs; structuring payment incentives; including FQHCs in state Medicaid medical or health home projects; and encouraging the Health Resources and Services Administration to use quality-of-care measures in making funding decisions. (Commonwealth Fund)
Innovation Center to tap 200 innovation leaders
CMS' Innovation Center will recruit up to 200 innovation advisors to find ways to improve care and reduce costs in Medicare, Medicaid and the Children's Health Insurance Program. Innovation advisors, selected on local and regional levels, will include clinicians, allied health professionals, health administrators, physicians and nurses. Skill sets will include health care economics and finance; population health; systems analysis; and operations research. Deadline for applications is Nov. 15; participants will be selected by Dec. 15. An initial group of 50 will gather in Washington, DC in January 2012.(HealthLeaders Media)
Nebraska a hotbed of VA PCMH transformation
Dr. Michael Hein and his colleagues at Grand Island VA clinic worked to develop a team approach to optimize care delivery; their efforts aligned with the patient centered medical home movement, the Journal Star reports. Three years ago, Grand Island's clinic hosted a VA medical home pilot, emerging as a top VA performer. Then, Lincoln's VA clinic joined the VA system-wide medical home transformation--and was singled out in a Commonwealth Fund report, which concluded the VA's early successes could push private practices and insurers to adopt medical home methods. (Journal Star)
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The Expanding PCMH: News and Updates
Orlando Health, as part of a recent affiliation agreement, will enhance the technology systems of Physician Associates, a 95-physician group. In turn, the group will move toward becoming accredited as a patient centered medical home. (Orlando Sentinel)
Wheeling Health Right has received Level 3 medical home recognition from NCQA. It is one of only two free clinics in West Virginia to receive NCQA certification and the only one to receive Level 3 recognition. (WTRF)
University at Albany Associate Professor of Health Policy and Management Timothy Hoff has been awarded a $100,000 research grant from the federal Agency for Healthcare Policy and Research to support a study examining patient centered medical home care for older adult patients within primary care settings. (Insurance Net News)
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MarketVoices...quotes worth reading
"'I just want my doctors to talk to each other.' In our work with patients and their families, this is the phrase that we hear over and over again. It is not a wish that should be taken lightly or ignored."
--Christine Bechtel, vice president, National Partnership for Women & Families, in the PCPCC report, Core value, community connections:Care coordination in the medical home.
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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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