Published 9/4/12 in Medical Home News
Never confuse motion with action.
A reporter called the other day to tell me that several local health systems now had medical homes. “I don’t think so,” I said. She was emphatic. “They just told me they do.” I asked whether their medical homes take fee-for-service reimbursement. “I guess so,” she said. “Doesn’t everyone?” “Almost everyone,” I said. “But if they do, that means they have a financial stake in delivering unnecessary care.” By definition, that’s counter to the idea of a medical home, which provides the right care at the right time in the right context. You can’t have it both ways.
Virtually every organization remotely related to primary care now wraps itself in the mantle of patient-centered medical homes (PCMH), and many flaunt their Recognition by the National Committee for Quality Assurance (NCQA) as proof that they’ve met a standard. Presumably employers and other purchasers, enthused by the buzz surrounding medical homes, assume these credentials translate organically to better care at lower cost.
Continue reading “Demanding More From Medical Homes”
Posted 2/22/12 on the Disease Management Care Blog
Is the pursuit of evidence-based medicine evidence based? That was the head-cramping question the Disease Management Care Blog grappled with when it read this just published Health Affairs article, Tool Used To Assess How Well Community Health Centers Function As Medical Homes May Be Flawed.
Readers will recall that the National Committee for Quality Assurance (NCQA) is a Washington DC-based not-for-profit that champions the use of performance measures to assess the quality of health care. Provider organizations go through an assessment process based on the measures and, if they pass muster, are “recognized” by the NCQA. The performance measures are based on peer-reviewed medical evidence, vetted by expert panels and then opened for public comment before they are finalized and used.
The DMCB knows this because it has served on two of the NCQA panels.
While its most visible activity has been the ranking of health insurers, the NCQA has been offering a soup of recognition, accreditation and certification programs for other types of provider organizations including the disease management vendors (for example) and, more recently, medical homes. More on that group of providers later.
Continue reading “Do Medical Homes Really Result in Better Diabetes Care?”