That is not, however, true of all programs that aim to manage chronic disease and demonstrate reduced costs.

As a cardiologist and CEO of Pharos Innovations, a company that focuses on managing chronic disease while demonstrating real reductions in avoidable hospital admissions and overall healthcare costs for Medicaid, Medicare, the VA, commercial health plans and provider systems, I think it’s important to set the record straight. There ARE well-proven ways to reduce costs AND keep patients healthier. (more…)

© Randy for The Collaborative Forum, 2010. | Permalink | No comment | Add to del.icio.us
Post tags: Care management, CMS, Disease management, Health plan, Medicaid, Medicare, Population Health, Remote Patient Monitoring

Feed enhanced by Better Feed from Ozh

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

Feed enhanced by Better Feed from Ozh

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

Feed enhanced by Better Feed from Ozh

Click on The Value Quadrant To Enlarge

Chronic disease is a problem that many physicians see daily in their clinical practices…I sure did.  It is one that causes countless unnecessary and avoidable hospitalizations.  This problem largely reflects a lack of simple coordination of information and care processes, as well as a lack of programs and approaches for patients with chronic disease to become more involved in their daily self-care.

Unfortunately, the burden of chronic disease falls largely to the elderly and vulnerable, in other words, Medicare and Medicaid beneficiaries.  As an example, if you are a Medicare beneficiary with congestive heart failure, you and your peers consume 40% of the Medicare annual budget.  A short list of chronic conditions account for 95% of Medicare expenditures, and over 80% of Medicaid costs.  It is a small wonder that the Medicare Trust Fund is predicted to be insolvent by 2018!

So…how can healthcare reform properly focus on achieving the biggest bang for the buck?  (In other words, move to the Value Quadrant). (more…)

© Randy for The Collaborative Forum, 2009. | Permalink | 2 comments | Add to del.icio.us
Post tags: Care coordination, Care management, Healthcare delivery system, Healthcare reform, Medicaid, Medicare, The Value Quadrant of Healthcare Reform

Feed enhanced by Better Feed from Ozh