The term medical home has become a catchphrase, tossed around by lawmakers, insurers and health policy experts.
Medical home blueprint
Four doc groups release guides seeking consistency
Meanwhile, countless medical-home demonstration projects are being launched by public and private payers, employers, clinical and academic centers and consumer advocacy groups across the country.
In response, four prominent physician groups last week released a set of 16 guidelines for patient-centered medical-home demonstration projects.
The term medical home is used pretty widely, said Shari Erickson, senior associate for practice advocacy and implementation for the American College of Physicians, one of the groups releasing the guidelines. We want innovation to occur in this area, but we also wanted to put forth guidance and promote consistency across the programs.
Others are cautioning against moving to a medical-home model too quickly (April 13, p. 17).
The American Academy of Family Physicians, American Academy of Pediatrics and American Osteopathic Association joined the ACP in issuing the guidelines. The four groups represent nearly 350,000 physicians.
Ted Epperly, president of the American Academy of Family Physicians, said in a written statement that the guidelines aim to help avoid contamination by nonmedical home projects, such as disease-management programs.
The guidelines focus on five areas: collaboration and leadership; practice recognition; practice support; reimbursement; and assessing and reporting results. In short, they are geared toward making sure that physicians are adequately involved, supported, paid and evaluated for their participation in medical home projects.
As for payment, the groups support reimbursement models that are broadly consistent with a bundled component covering physician and staff work and expenses; a visit-based fee component; pay-for-performance using evidence-based quality, cost and patient-satisfaction models; and recognition of varying patient-case mix and complexity.
With an emphasis on health information technology, care coordination and improving clinical outcomes, the guidelines are somewhat consistent with those released by Americas Health Insurance Plans, the trade group for insurers, last June (June 30, 2008, p. 15). AHIPs guidelines state that pilot testing should be completed and evaluated fully before the concept is broadly implemented.
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