Tuesday, October 27, 2009
Medicare Medical Home Demo Cancelled. Medicare Medical Home PILOTS Are On The Way
In a prior post, the Disease Management Care Blog broke the news that the Medicare Medical Home Demonstration had been placed on perma-hold by CMS. The announcement is now official, and you can read all about it and many of the implications at Vince Kuraitis' e-CareManagement Blog.
As pointed out in e-CareManagement, the purpose of a 'demo' is to ask 'if' a patient care intervention works, usually by comparing the outcomes of the patients in the intervention group to the outcomes of patients in a parallel control group. The Medicare Medical Home Demonstration is being effectively cancelled because the House Bill 3200 proposes a Medical Home 'Pilot' Program. The DMCB interprets the purpose of a pilot is to ask 'how' a patient intervention works. 'If' is first generation Ver. 1.0. 'How' is second generation Ver. 2.0
How could medical home 'pilots' be conducted by CMS? One big hint lies in the Green Mountain State, where the Secretary of HHS announced that Medicare will participate in a 'multi-payer' 'demo' evaluation. Don't let the word demo fool you. The bad news is that the multi-payer dimensions of this initiative will complicate any formal and traditional assessment of the impact of the medical home for fee-for-service Medicare beneficiaries. The good news is that this looks and feels like a pilot in which CMS will gain a treasure trove of experience on making the medical home 'work' in the real world.