Medicare Moving into Medical Home

Monday, September 21st, 2009
This post was written by Melanie Matthews

Medicare is moving into the Medical Home in a big way. Last week the federally administered health insurance system for persons 65 and older got the green light to participate in state multi-payor patient-centered medical home (PCMH) initiatives — a featured story in this week’s Healthcare Business Weekly Update. Medicare is also set to launch its own three-year PCMH demo that will pay eligible physicians a monthly care management fee for medical home services for high-need patients — those with prolonged or chronic illnesses that require regular medical monitoring, advising or treatment.

This is good news on all fronts. With the management of chronic conditions in older adults taxing healthcare resources, Medicare should be participating in multi-payor PCMH collaborations. In 2008, Medicare’s annual costs were 3.2 percent of the GDP. According to the CMS Chronic Condition Data Warehouse, 50 percent of Medicare FFS beneficiaries were receiving care for one or more chronic conditions in 2005. The medical home is built to manage the complexity of care and multiple medical providers required by multi-morbid patients.

With evidence mounting that the medical home produces better care at no added cost, it makes sense for Medicare to adopt the patient-centered team approach for its beneficiaries. Participating physicians are likely to see results well before the pilot’s end, especially among baby boomer patients that embrace disease management e-health tools wired into the medical home.

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