Clearly, this set of recommendations resonates with us at Pharos Innovations. These recommendations are directly aligned with the paradigm of physician- and patient-centric care coordination that we created with Tel-Assurance^®.  The AHA recommendations are all about accountability: the patient’s as well as the physician’s. Accountability brings better results with healthier patients and reduced hospital readmission rates—both which on the face of it, are great things.

Unfortunately, our healthcare delivery system, as currently designed, is not set up to maximize patient and physician accountability. Specifically, in the way healthcare providers are currently incented for the quantity of care, not the quality. The good news is that this is changing. (more…)

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As a newly appointed member of The Care Continuum Alliance’s board, I am humbled by the great minds working together to solve our healthcare crisis. In years past, I have witnessed many call-outs of the problem and seen many potential solutions arise. Notably, one major element has been missing from the solution — collaboration. This year is different. I walked away with the sense that our industry is finally in agreement that change is needed – that what has been is not sustainable in the future – and that collaboration is the key to that change. I also walked away with the keen sense that the DMAA: The Care Continuum Alliance is a catalyst to help us move in that direction.

I am excited for the work ahead of me and The Care Continuum Alliance’s board as we help guide this movement.There were three other key themes that marked this year’s meeting, which I’d like to explore. These themes, to an outside observer, might seem unrelated in many ways. But my sense is that taken together, they represent an important milestone in the healthcare industry, perhaps even a pattern – one that appears to represent nothing short of a seismic shift. (more…)

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Table of contents for Medicare's Medical Home Challenge

1. The Medicare Medical Home Demonstration: Crawling Out From Under the Rock – Part II

Vince’s post begs the question: “So…if one were to redesign the MMHD to fulfill the potential for both improving care quality (through access to an appropriate “Medical Home”) while simultaneously reducing healthcare costs, where might we start?”

Vince points us in the right direction in his post, calling our attention to the work of Randall Brown in his report of another CMS demonstration, the Care Coordination Demonstration. Brown points out two key observations:

1. Care Coordination, to save money, must start with the “right” population target; and,

2. Care Coordination interventions can only save money if they don’t COST more than about $120 per participant per month (the amount likely to be saved from a well-designed intervention).

In other words, the solution to the dilemma has two aspects: 1. FOCUS and 2. EXECUTION. (more…)

© Bonni for The Collaborative Forum, 2009. | Permalink | 3 comments | Add to del.icio.us
Post tags: Care coordination, Care management, CMS, EMR, Medical Home, Medicare, Remote Patient Monitoring

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Table of contents for Medicare's Medical Home Challenge

1. The Medicare Medical Home Demonstration (MMHD): Between a Rock and a Hard Place

by Vince Kuraitis, Principal, Better Health Technologies

“Between a rock and a hard place.” Meaning:  In difficulty, faced with a choice between two unsatisfactory options. The Phrase Finder

Before it has even started, the Medicare Medical Home Demonstration (MMHD) is in BIG trouble.

Congress passed legislation authorizing the MMHD in 2006. It is scheduled to begin in January 2010. The MMHD is Medicare’s major test of the Patient Centered Medical Home model being promoted by primary care physicians.

Between the time the MMHD was authorized and now, we’ve learned a lot about what works and what doesn’t work in Medicare care coordination programs. The MMHD is between a rock and a hard place — conflicted by two “must achieve” objectives that are diametrically opposed:

• As a political matter, the MMHD must save money
• As currently structured, the MMHD cannot save money

Let’s look at each half of the dilemma separately.

As A Political Matter, the MMHD Must Save Money

The “Thought Leader’s Corner” in the May 2009 issue of Medical Home News poses a provocative question:

Q: How important will it be for future Medical Home development to be able to show that the Medical Home model generates real, well documented cost savings?

Here are excerpts of how a spectrum of political and health system leaders answered the question: (more…)

© Vince for The Collaborative Forum, 2009. | Permalink | 14 comments | Add to del.icio.us
Post tags: Care coordination, Care management, CMS, Healthcare reform, Medical Home, Medicare

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