Archive for August, 2009

Medication Adherence: A Value Quadrant Opportunity? Part III

Friday, August 21st, 2009

In a previous post, called Medication Adherence Part II, published July 31st, I unpacked 5 of the 10 recommendations from a recent New England Healthcare Institute (NEHI) report, ”Thinking Outside the Pillbox”.  Let me hit the remaining 5 recommendations now.  Read the rest of this entry →

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

Tuesday, August 4th, 2009

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: Read the rest of this entry →

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