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Payment Method for Patient Centred Medical Homes

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What kind of payment method is more suitable for reimbursing Patient Centred Medical Homes (PCMH)?

Research confirms that medical homes can lead to higher quality and lower costs and can improve patient and provider experiences of care. Is this a reality or not? What example?

How is this program implemented?

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What type of payment methods more suitable for reimbursing PCMH?

The most effective methods for reimbursing PCMH entail combining traditional fee-for-service for office visits with a three part model. This includes monthly care coordination payments for the physician and non-physician work that falls outside of a face-to-face visit and for the system infrastructure, which is required for better outcomes. ...

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This solution discusses payment methods for patient-centred medical homes.

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Patient Centered Medical Homes

SECTION ONE

1. Discuss the difference between Patient Centered Medical Home and Health Management Organization.
2. Explain why Health IT, workforce development, and payment reform are critical to success of Patient Centered Medical Home.

Useful Readings:

- Patient Centered Primary Care Collaborative (2010) Joint Principles of the Patient Centered Medical Home. Available at http://www.pcpcc.net/content/joint-principles-patient-centered-medical-home (Retrieved 08/21/2012)
- Patient Centered Primary Care Collaborative (2010) Introduction to the Patient Centered Medical Home. Available at http://www.pcpcc.net/content/emmi (video) (Retrieved 08/21/2012)

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SECTION TWO

Conduct some preliminary research on a Patient Centered Medical Home demonstration/pilot project in your state. The PCMH project can be a demonstration program initiated by your state government or by an insurance company. Please write a paper answering the following questions:
1. Which populations (e.g. adults, children, or elderly) and what conditions/diseases are targeted?
2. Who are the participating payers?
3. What type of insurance product (e.g. HMO or PPO) does the participating payers include?
4. Who are the participating providers? (Please just list the type of providers, such as hospitals or community health centers)
5. How are the participating providers reimbursed?
6. Please briefly describe the result and the progress of this PCMH program? (no more than 250 words)
7. What kind of payment method is more suitable for reimbursing PCMH? Justify your answer ( 1or 2 paragraphs)

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