“Medical homes” aren’t cutting Medicare costs

Conclusion I have described three reasons why MedPAC’s pessimistic assessment of the PCMH as an APM prototype is correct: Medicare’s PCMH demos are showing that PCMHs cannot cut Medicare costs and are having little impact on quality; PCMHs are expensive, and are probably costing doctors more than they are getting back in the form of “care management fees” and “shared savings”; and PCMHs can add to the emotional stress that is already at epidemic levels among physicians. For all these reasons, we may conclude that the PCMH cannot play the role of an APM under MACRA. But that doesn’t mean CMS won’t force the PCMH (or something quite like it with a new and equally saccharine name) to play that role. CMS is not acting entirely rationally these days. It appears CMS intends to cram the square MACRA peg through the round hole of reality regardless of the consequences. [1] Readers should be aware the law and CMS make a distinction between “initiatives” and “demonstrations.” I use only “demonstration” here. [2] The first-year evaluation of the MAPC demo was released in January 2015 along with the first-year evaluation of the CPC demo. Although the second-year evaluation of the CPC demo was released in April 2016, the second-year evaluation of the MAPC demo has still not been released. On April 25, I sent an email to RTI International, the author of the first-year evaluation, asking why the second-year evaluation has not been released. As of April 29, I have...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs