Committee debates national medical home standards

Dr. Mark Schaefer, the director of the state Office of Health Reform & Innovation (Christine Stuart photo)
Dr. Mark Schaefer, the director of the state Office of Health Reform & Innovation (Christine Stuart photo)

HARTFORD, Conn. – More than two years ago, Connecticut launched a patient-centered medical home model for its Medicaid population. It’s a model where a patient relies upon their primary care physician to coordinate all of their care and actively remind them about preventive screenings or exams.

The idea behind the model and the payment method was to increase access and lower the amount of money the system pays to treat these patients by improving their health outcomes and keeping chronic conditions under control.

In order for a physician’s office to receive a higher reimbursement for these patients they have to meet or prove that they are on a path to meet standards set forth by the National Committee for Quality Assurance (NCQA). There are about 1,193 providers serving more than 250,000 Medicaid patients who are qualified to receive these higher reimbursements. It costs a practice of about five physicians $2,500 a year to maintain their certification.

Advocates say that’s a small price to pay for the additional $150,000 the average practice receives in higher reimbursements for managing the care of their Medicaid patients.

See the complete story at CT News Junkie.



2 responses to “Committee debates national medical home standards”

  1. Rod Lopez-Fabrega

    What do Medicaid AND Medicare patients do when their primary physician decides to convert his/her practice into “boutique” medicine?

    Who then becomes the organizing filter to coordinate all of the patient’s care and actively remind the patient about preventive screenings or exams?

    Another good idea undercut by greed…

  2. Suzanne

    Mr. Lopez-Fabrega, I sympathize. The patients have to “go back to the drawing board” and seek out another PCP who takes Medicare/Medicaid. It is not easy but there are lists and I suggest an interview before deciding who is best for their care. Navigating current medical care is anything but easy especially with people who are already ill. The risks of subpar non-coordinated care are great. It is up to the patient or their advocate to be vigilant and self-protective. Of course, it should not be this way but the days of dependable, “the doctor knows” kinds of approaches have been over for a long time. I personally recommend a health care advocate: an astute friend, family member or, if possible, para-professional in the health field to be present for complicated MD appointments. Especially when a patient is ill, it is hard to remember to ask the right questions and remember the answers much less all of the necessary queries about one’s condition. You are right: MD movement to a more profitable working model, away from the hassles of insurance reimbursement and insurance company control is hurting all of us. A patient action plan is the only thing that can counteract this trend.

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