Medical Home Reimbursement Models:
Funding Patient-Centered Care with
Multi-Stakeholder Collaborations

PRE-PUBLICATION OFFER: Save 15 percent and pay only $124.95
when you order by November 25, 2008. This product will ship
on November 26, 2008.


There's no question that the healthcare community has embraced the patient-centered
medical home (PCMH) model of care. To date, there are 22 multi-stakeholder pilots
in 16 states, with eight state Medicare pilots scheduled for 2009. The joint principles
of the PCMH have been endorsed by the AMA, AAFP, AAP, ACP and the AOA.

However, with the cost of transforming a physician practice into a medical home
estimated at 30 percent over current fee-for-service reimbursement levels, acceptable
funding formulas are still needed to cover construction and maintenance of medical homes.

Medical Home Reimbursement Models: Funding Patient-Centered Care with
Multi-Stakeholder Collaborations
presents three ongoing medical home pilots built on a
variety of reimbursement models.

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Medical Home Reimbursement Models: 
Funding Patient-Centered Care with Multi-Stakeholder Collaborations

This 35-page special report provides an opportunity to evaluate
three PCMH financial models and benefit from the experiences
of multi-stakeholder collaborations. These case studies reflect
early collaborations by Colorado, Ohio and New Hampshire
providers, employers and public and private payors to build
reimbursement structures that reward providers for care
coordination and preventive efforts without adversely impacting
healthcare costs.

This report also provides details on the following:

and much more.

View the full table of contents and order your copy today at:
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Colorado is deeply involved in medical home initiatives at the state
and national levels. In the first case study, Lesley Reeder, R.N., B.S.N.,
quality improvement specialist for the Colorado Department of Health Care
Policy and Financing, shares details on the Colorado Children’s Healthcare
Access Program (CCHAP), which provides medical homes for Medicaid and
SCHIP beneficiaries. CCHAP offers enhanced reimbursement for preventive
care for 59 providers who care for 10,000 children. A physician champion and
a supportive governor figure largely in the success of this small pilot, which
is a stepping stone to larger medical home pilots in the state.

Colorado also participates in the Multi-Stakeholder Patient-Centered Medical
Home Pilot, described in this book by Julie Schilz, co-chair of the Center for
Multi-stakeholder Demonstrations and IPIP manager for the Colorado Clinical
Guidelines Collaborative. In this multi-state pilot, Colorado is partnering
with Ohio and a mix of employers and public and private payors to fund medical
homes. Schilz provides details on its three-tiered reimbursement model (an approach
recommended by the Patient-Centered Primary Care Collaborative) and describes
other considerations, including sensitivity toward antitrust regulations.

Thirdly, from New Hampshire comes details on a payor-provider medical home pilot from
Barbara Walters, M.D., senior medical director of Dartmouth-Hitchcock Medical Center.
Seasoned from its participation in the CMS Group Physician Practice demonstration
project for Medicare beneficiaries, Dartmouth-Hitchcock partnered with Cigna to create
a medical home pilot whose reimbursement structure starts with quality, not cost. This
collaboration with a commercial payor allowed Dartmouth-Hitchcock to apply lessons
learned from the CMS demo as well as the clinical model it had developed.

Dr. Walters also shares details on the separate New Hampshire Citizens Health Initiative,
which is readying a multi-site multi-stakeholder medical home pilot similar to Colorado's.
Colorado even advised New Hampshire during pilot development. The New Hampshire
initiative will launch in 2009 and will provide infrastructure and practice support for
participating practices who have not yet clinically designed themselves in a medical
home model.

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your company's computer network for an unlimited number of additional workstations within
your organization for a one-time fee. To have this valuable resource on your network,
or to inquire about ordering bulk copies in print or Adobe PDF, please e-mail
Deirdre McGuinness at dmcguinness@hin.com.


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Medical Home Reimbursement Models:
Funding Patient-Centered Care with Multi-Stakeholder Collaborations

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Medical Home Reimbursement Models:
Funding Patient-Centered Care with Multi-Stakeholder Collaborations


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