Patient Centered Medical Homes

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Patient Centered Medical Homes
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Our Health Care System The Next Generation
20th Century 21st Century
Patient Compliance Patient Experience Activation
Cost Value (cost/quality)
Encounter driven payment Pay for coordinated care over time with positive health outcomes
Data Timely information for decision making for patients, provider s, and policy makers
Access Population health with no health disparities
Acute care based Primary Care Based
Care is supply/demand driven Care is evidence-based safe
Autonomous Providers and health care organizations Multidisciplinary teams Regional Collaboration within health system and among community stakeholders
Uncoordinated interventions, numerous performance measurements and payment structures Focused aligned system improvement patient, provider, health system and policy levels
Continuous Professional Education Continuous Professional Improvement
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The Models for Reimbursement

• FFS with discrete new codes
• FFS with higher payment levels
• FFS with supplemental lump sum payments
• FFS with PMPM fee
• FFS with PMPM fee and with P4P
• FFS with PMPY payment
• Comprehensive Payment with P4P

Adapted from Michael Bailet
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Reference Sites
National Academy for State Health Policy
http//www.nashp.org/ Patient Centered Primary
Care Collaborative http//www.pcpcc.net/ or
www.patientcenteredprimarycare.org The
Commonwealth Fund http//www.commonwealthfund.org
/programs/programs_list.htm?attrib_id11932