Managed Care - December 2008 - (Page 28)

Home, (Not So) Sweet, Medical Home It was the hot topic at the DMAA annual conference because attendees could not agree on its viability By Maureen Glabman Contributing Editor he “medical home” was not far from many presenters’ scripted notes at the disease management industry’s annual meeting. “It’s the hottest thing out there,” said one speaker, Lisa Latts, MD, vice president for “programs in clinical excellence” at WellPoint, who indicated that her company is undertaking multiple tests of the concept. About 800 registrants from as far as China attended the three-day event just before Thanksgiving in Hollywood, Fla. In at least four seminars, presenters demonstrated how disease managers can jockey for a seat at the medical home dining table, in contrast to last year’s forum when there were no named medical home lectures. This was the tenth annual meeting of what now calls itself DMAA: The Care Continuum Alliance. It had been the Disease Management Association of America. Some rendered unabashed support. “I see the medical home as an entirely new business opportunity,” said Tracy Moorhead, DMAA’s president and CEO, between sessions. Others, more skeptical, saw the medical home as an example of a health system grasping at straws to remedy runaway costs, promote better health outcomes, and cope with a dire shortage of primary care physicians. “The medical home is the most overrated concept,” said the industry pundit Al Lewis, president of the Disease Management Purchasing Consortium, at an off-site vendor dinner given by Pharos Innovations, a remote patient-monitoring company. “Where are the alleged savings supposed to come from?” from Congress.” Appelgate was referring to the three-year, up to eight-state, high-need beneficiary Medicare medical home demonstration project starting in 2010 that will pay primary care physicians $40–$52 per member per month to coordinate their patients’ care. Increased compensation could total as much as $100,000 each per year. T Definition Sometimes called the “patient centered medical home,” the term is so riddled with confusion that several speakers were obliged to define it. In general, it allows primary care physicians to be paid extra to coordinate specialist care and to supervise a team of allied health professionals who focus on prevention and disease management. The uptick in payment would put primary care physicians on a more even footing with specialists, who earn substantially more, a situation causing a dangerous shortage in the number primary care physicians, according to the American College of Physicians, one of the primary care trade groups pushing the concept. A fog over the medical home extends to those who might staff it. “The jury is still out on the type of medical professionals that belong in a medical home,” said another speaker, Vincent Kuraitis, JD, principal of Better Health Technologies, a consulting company. Suggestions include an interdisciplinary team with a primary care physician at the helm who directs: A medical assistant who routinely checks preventive updates before patients are seen and prepares orders for the physician to sign for such things as colon cancer screening and tetanus shots • A shared clinical pharmacist who examines shopping bags that some patients bring, laden with herbs, vitamins, over-the-counter drugs and prescribed medications, for drug interactions and for duplicated, unnecessary, or dangerous drugs • Christmas gift William Appelgate, PhD, executive director of the Iowa Chronic Care Consortium, said the medical home is “a Christmas gift to family practice docs 28 MANAGED CARE / DECEMBER 2008

Table of Contents Feed for the Digital Edition of Managed Care - December 2008

Managed Care - December 2008 Editor's Memo Contents Legislation & Regulation News and Commentary Medication Management Compensation Monitor ICD-10 Offers Huge Opportunity, Challenge Part D at a Crossroads Plans Can Weather the Financial Crisis DM vs. Medical Home? Tackle Prediabetes Reasonable Approach to Morning Sickness Formulary Files Tomorrow's Medicine Outlook

Managed Care - December 2008

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