Medical Home Bulletin             |           September 17, 2009              |           Volume One Issue Seven
Complimentary from the publishers of Medical Home News      www.MedicalHomeNews.com

  
White House Announces a State-Level Medicare Medical Home Demonstration

The Administration took the concept of a Medicare Medical Home Demonstration off the inactive list on September 16 with a special White House announcement featuring HHS Secretary Kathleen Sibelius, White House Office of Health Reform Director Nancy Ann deParle, and Vermont Governor Jim Douglas.   Apparently looking for a demonstration construct that would have a higher level of success than a Medicare-only project at the physician practice level, the new demonstration has a number of new features:

• Modeled after the Vermont experience, the new demonstration will be available only for State applicants

• Medicare will in fact be joining projects which already feature Medicaid and “a sufficient number” of private health insurers, as does the Vermont Blueprint, so that the new project has the breadth and strength of an all-payer approach.

• The demonstration, while modeled after the Patient-Centered Medical Home, even has a new name – Advanced Primary Care (APC).

 Other features of the demonstration will remain the same:

• HHS will manage a competitive application process, with State applications solicited this fall.

• Projects will last for three years.

• The projects must demonstrate net savings to the Medicare trust fund.

• States must certify that they meet a variety of baseline conditions, including the participation of both Medicaid and private payers as well as a majority of primary care physicians in the demonstration areas, use of health IT, and integration of public health and wellness programs.

• Implementation is anticipated in 2010.

• A rigorous research design would measure whether projects reduced unnecessary expenditures, improved quality broadly defined, increased patient participation, and reduced Medicare utilization and expenditures overall.

There was no indication as to how many State projects could be selected.  The announcement also made it clear that the Administration would still proceed with the Medicare Medical Home Demonstration (MMHD) required under the Medicare Improvements for Patients and Providers Act (MIPPA) and the Tax Relief & Health Care Act of 2006 (TRHCA).  The White House announcement can be found at: http://healthreform.gov/newsroom/factsheet/medicalhomes.html