Sunday, April 25, 2010

Medical Homes & CMS' Chief Actuary: The Mirrored Gazing Globe of Health Reform?

The Disease Management Care Blog believes a gazing ball would be a handsome addition to our yard. In its opinion, a mirrored globe would be a festive compliment to the property and introduce a distinct classiness that is absent around our neighborhood. Yet, the DMCB spouse's opaque logic has inexplicably vetoed the idea. What gives?

And the same cold water could end up being splashed on the equally good ideas behind the various pilots and demos in the recently passed Patient Protection and Affordable Care Act (APPAC). In Section 3021 (p. 271), the yet to be formed Center for Medicare and Medicad Innovation is charged with testing various models of care including medical homes. The HHS Secretary may, 'through rulemaking,' expand the models if:

"...the Chief Actuary of the Centers for Medicare & Medicaid Services certifies that such expansion would reduce program spending under applicable titles."

Egads. Getting the CMS Chief Actuary to certify there is reduced program spending may be a tough hurdle. According to this news report, this is the same equally hardnosed Chief Actuary that recently calculated that the newly passed health reform bill will lead to "increased costs associated with the expansions of health insurance coverage" and that "the longer-term viability of the Medicare ... reductions is doubtful."

The policy response from the White House and its Favored Chosen, of course, is spin. Given the Chief Actuary's uncanny similarity to the DMCB spouse, however, the DMCB isn't sure that spin will meet "reduce program spending" muster.

In the meantime, the DMCB is moving on. Inspired by the release of the movie Avatar on DVD, its latest pilot ornament idea is to festoon our shrubbery with solar powered glo-in-the dark Pandora-like butterflies. The DMCB looks forward to the DMCB spouse's analysis and the expansion of this meritorious landscaping model.

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