Not only do the goals for patient-centered medical homes and accountable care organizations align, but also they match those of the CMS "triple aim" of better care, better health and lower cost, according to a report generated by a stakeholders consensus meeting hosted by the Patient-Centered Primary Care Collaborative and sponsored by the Commonwealth Fund and the Dartmouth Institute for Health Policy and Clinical Practice.
Primary-care groups: Goals for ACOs align with CMS aims
The report, "Better to Best: Value-Driving Elements of the Patient Centered Medical Home" (PDF), includes five consensus statements—each accompanied with a set of recommendations—that participants in the Sept. 8, 2010, meeting said could build on medical-home demonstration project findings and synchronize innovations to create a more sustainable healthcare system.
The report quoted Dr. Allan Goroll, professor of medicine at Harvard Medical School, who said that payment reform is necessary to ensure healthcare is delivered properly. "We can barely afford to do the job we need to do today," Goroll said in the report. "And we certainly don't have the resources necessary to do the job expected of us going forward."
Among the recommendations made by Goroll was a "least change model" that included traditional fee-for-service payments in addition to a management fee and performance rewards. Goroll said this model could "lend itself to primary-care practice transformation" even among those unwilling to move toward accountable care models.
The report emphasized the need for measurements that ensure that the focus does not move away from the patient and too much toward cost containment and reward efforts such as excessive underutilization of healthcare resources.
Ultimately, according to the report, "a leadership cadre that will speak loudly and clearly" to support medical homes and ACOs is needed, as well as a commitment by payers, providers, academics, employers, government and consumers to "stay together for the long haul."
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