A Medical Home By Any Other Name…

Monday, November 2nd, 2009
This post was written by Melanie Matthews

CMS’s shelving last week of its widely anticipated Medicare Medical Home Demonstration (MMHD) elicited a strong response from our community. Citing language in pending legislation that would repeal the MMHD and replace it with a similar pilot, CMS reiterated its support for multi-payor pilots like the 2010 Multi-Payor Advanced Primary Care Initiative (MAPCI) Practice Demonstration, described in the Sept. 21 Healthcare Business Weekly Update. HHS equates the advanced primary care model with the medical home.

Many questions surround CMS’s shift in focus, including the rationale for a new label for the medical home model when the current one is widely accepted and understood. When asked about CMS’s decision during last week’s Healthcare Trends in 2010: Marketplace and Health Reform Drivers webinar, healthcare consultant William DeMarco said that a focus on accountable care organizations (ACOs) — networks of primary care physicians, one or more hospitals and subspecialists that provide patient-centered care — will likely replace a lot of discussion of the medical home. “There must be 10 different varieties of medical homes,” said DeMarco. “CMS is likely looking for a more stringent definition of the ACO. The original demo project did not include a discussion of bundled services, not only for providers but for hospitals and other services. That’s something CMS needs to do in order to make it work.”

Healthcare consultant and blogger Vince Kuraitis does a great job of analyzing the CMS announcement, the future of Medicare and the rise of the MAPCI in a recent e-CareManagement blog post.

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