Under the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration, the Centers for Medicare & Medicaid Services (CMS) joined state-sponsored initiatives to promote the principles that characterize patient-centered medical home (PCMH) practices. After a competitive solicitation, eight states were selected for the MAPCP Demonstration: Maine, Michigan, Minnesota, New York, North Carolina, Pennsylvania, Rhode Island, and Vermont. While all eight states were slated to start July 1, 2011, only New York, Rhode Island, and Vermont became operational on that date.
A review of two years' worth of healthcare claims data on thousands of patients reveals, contrary to the prevailing view, that unlimited primary care drives down overall costs while improving patient outcomes and experience.
Importance Patient-centered medical homes have not been shown to reduce adverse outcomes or costs in adults or children with chronic illness.
Objective To assess whether an enhanced medical home providing comprehensive care prevents serious illness (death, intensive care unit [ICU] admission, or hospital stay >7 days) and/or reduces costs among children with chronic illness.
Data analyzed from 2013 on quality, outcomes and cost measures from Humana’s accountable care organization programs for about one million Medicare Advantage members shows a number of measureable improvements, according to the insurer.
Humana compared the measures of ACO patients with members treated in the traditional Medicare Advantage fee-for-service and original Medicare programs. Results show that ACO providers under a value-based reimbursement model had an average HEDIS Star score of 4.25 compared with providers not in an ACO, who averaged 3.65.
Medical Home Network announced today the results of a data review of its model of care program for Illinois Medicaid patients as implemented at Esperanza Health Centers' three primary care practice sites in Chicago's Little Village neighborhood on the southwest side, which shows as high as a 130.4 percent increase in timely patient follow-up visits, 25 percent decrease in 30-day hospital readmissions, and a decrease in the overall cost of care for each patient since the introduction of the new care model in December of 2012.
This dataset presents data on Performance Year 1 final financial reconciliation and quality performance results for ACOs with 2012 and 2013 agreement start dates. Performance year 1 is a 21- or 18-month period for ACOs with 2012 start dates, and a 12 month period for ACOs with 2013 start dates. ACOs that generated savings earned a performance payment if they met the quality standard. For the first Performance Year, CMS defined the quality performance standard as complete and accurate reporting for all quality measures.
When the Accountable Care Collaborative (ACC) launched in 2011, the Department’s goal was not to simply deliver health care, but to improve the health of Medicaid clients. Many factors contribute to health: personal health behaviors, access to medical care, good provider-patient communication, a connected health system and access to resources to meet basic needs.
