The Rumor Mill About the Medical Home Demo (and good news about today's meeting at the White House on health reform)

The Rumor Mill:

The Disease Management Care Blog has heard a completely unconfirmed report that CMS will delay until 2010 the announcement about which States will be chosen to participate in the Medicare Medical Home Demonstration.

It would make sense. The Medical Home may well be a component of major healthcare reform and it wouldn't make sense to have a concurrently running demo. What's more, my primary care colleagues are concerned that participation by smaller primary care sites may be put out of reach by imposing a Tier 3 requirement. Perhaps the whole thing is so star crossed, it should be scuttled.

Let The Horse Trading Begin

Nothing like being invited to the White House for a friendly chat. The DMCB would have liked to been in on some of the background conversations leading up to today's meeting on healthcare reform. If the details about simplification, efficiency, coordination and improvement seem vague, it's because they are. Think of this as a warm up to the painful details that will be discussed at the May 12 U.S. Senate Finance Committee.

Unlike the Bank CEOs, however, everyone hopes they have a chance getting something in return. DMCB readers are already aware of AHIP's posture toward the public insurance option. Kaiser's excellent Health Policy Daily Report points out pharma is holding out to keep cost-benefit analyses out of comparative effectiveness research while providers want to avoid onerous take it or leave it fee schedules. Care to guess what the physicians would like?

However, the disease management community doesn't need to necessarily 'trade' anything. Today's White House meeting affirmed that billions in healthcare costs can be achieved via

'Encouraging coordinated care, both in the public and private sectors, and adherence to evidence-based best practices and therapies that reduce hospitalization, manage chronic disease more efficiently and effectively, and implement proven clinical prevention strategies.'

The DMAA has it right. If there is any hope of intelligently reducing healthcare costs in the coming years, we have to address the burden of chronic illness. Let the details begin.