CMS announces new Primary Care delivery model

Public and private payers can apply through June 1 to participate in a new medical home model that will build on the Comprehensive Primary Care model to help practices support patients with serious or chronic diseases, the Centers for Medicare & Medicaid Services announced today. 

Under the CPC+ model, CMS will partner with insurers and Medicaid agencies in up to 20 regions and up to 5,000 practices to provide monthly care management fees based on beneficiary risk tiers.  The model can accommodate up to 5,000 practices, 20,000 doctors and the 25 million people they serve.

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High-intensity primary care may help lower costs and improve quality

“High-intensity” primary care, a model of care similar to the Patient-Centered Medical Home specifically for patients with chronic and multiple conditions, shows promise in lowering costs and improving quality, according to a press release by the National Institute for Healthcare Reform.
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Medicare to Participate in State Multi-payer Health Reform Efforts to Improve Quality and Lower Costs

The Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) invited states to apply for participation in the Multi-payer Advanced Primary Care Practice Demonstration, an initiative in which Medicare will join Medicaid and private insurers to assess the ability of patient-centered "medical homes" to improve the delivery of primary care and lower health care costs.
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Prevalence of chronic conditions among children and youth increased from 1988 to 2006

Researchers at MassGeneral Hospital for Children and Harvard School of Public Health in Boston examined the prevalence of chronic health conditions including obesity, asthma, other physical conditions, and behavior/learning problems in three consecutive groups of children, each over a six-year period.
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HHS announces ARRA grants for prevention, wellness

The Department of Health and Human Services will award $120 million in American Recovery and Reinvestment Act (ARRA) funds to states and territories for prevention and wellness programs. The application deadline is Nov. 24.  The funding is part of the Communities Putting Prevention to Work initiative. 

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Study suggests millions of savings from mobile health clinic

A Harvard Medical School mobile health clinic that provides free preventive health care and counseling to low-income residents throughout Boston saved about $3.1 million last year in avoided ED visits and appeared to generate roughly $20 million in total annual savings when researchers accounted for added “life years” stemming from the intervention, according to estimates published in BMC Medicine.

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Prevention should play critical role in reforming health care

According to the Trust for America's Health (TFAH), an investment of $10 per person per year in proven community-based programs to increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save the country more than $16 billion annually within five years. This is a return of $5.60 for every $1. Out of the $16 billion, Medicare could save more than $5 billion, Medicaid could save more than $1.9 billion, and private payers could save more than $9 billion.

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Evidence suggests medical home may improve quality and reduce costs

The medical home is by now widely recognized as a promising approach to delivering comprehensive care and ensuring the best outcomes for patients. Physician practices and clinics that provide a "patient-centered" medical home deliver primary care that includes around-the-clock access to primary and specialty care, as well as physician and patient access to electronic health records.

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Uninsured and Medicaid Patients More Likely to Receive Preventive Care in Community Health Centers

Despite having a more vulnerable patient mix, community health centers (CHC) out-perform other primary care providers in the use of preventive care by both Medicaid and uninsured patients. A new study from The George Washington University Medical Center’s School of Public Health and Health Services (SPHHS) observes differences of as much as 22 percent between the receipt of preventive care in CHC and non-CHC settings. The study is part of a series of health policy research briefs prepared by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative.

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Individuals with Chronic Disease Often Go Without Treatment

Many Americans with chronic diseases are forgoing needed care because they lack health insurance coverage, according to a report released Tuesday in the health journal Annals of Internal Medicine ( www.annals.org , subscription required).

The study, which says it is the first in recent years to address the prevalence of chronic conditions among the uninsured, estimates that of the country's 47 million uninsured, 11.4 million are working-age adults suffering from at least one chronic condition, such as cardiovascular disease, diabetes or asthma.

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Urgent care clinics thriving despite quality concerns

A recent article in the Wall Street Journal noted that patients seeking alternatives to the growing lines in Emergency Departments are increasingly looking at urgent care clinics. The Journal reports that these facilities aim to fill the gap between the growing shortage of primary-care doctors and a shrinking number of already-crowded hospital emergency departments, with no appointment necessary and extended evening and weekend hours. Urgent-care clinics are staffed by physicians, offer wait times as little as a few minutes and charge $60 to $200 depending on the procedure -- a fraction of the typical $1,000-plus emergency department visit. Some offer discounts and payment plans for the uninsured; for those with coverage, co-payments vary by insurance plan but may be less than half the amount of an ER visit, which can range from $50 to $200. (SOURCE: Wall Street Journal, Landro, www.wsj.com, August 6, 2008, Page D1, Subscription Required)

Government, insurers testing medical home model to curb costs

A growing number of public and private payers nationwide have launched experimental programs that seek to reduce downstream medical costs by rewarding primary care physicians (PCPs) who manage patients under a "medical home" care model, the New York Times reports. Under such pilot programs-which are currently underway in at least a half-dozen states-PCPs are hiring additional staff to help monitor patients’ treatment and follow-up, helping patients pre-empt problems by sending reminders about preventive tests, and enabling patients with medical emergencies to secure office visits on short notice.

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