Medical Home Monitor
Medical Home Monitor
February 17, 2009
Vol. I, No. 11

Medical Home Monitor Archives

Medical Home Q&A:
Communicating with the
Medicaid Population

Home Visits and Caseloads

Q: Given the sometimes transient nature of the Medicaid patient, what are some ways that organizations can locate and communicate with this population?

A: In McKesson's pay-for-performance (PFP) program for physicians, if we're having difficulty locating a patient, our care managers ask the PCPs what information they have in their files. We'll compare notes about recent phone numbers and addresses, and it's one of the things that we pay for in our PFP program. We've also started to collect e-mail information from our consumers. The Medicaid population is increasingly becoming more computer-savvy. Five to 10 years ago, using alternative communication strategies with a Medicaid population was viewed as being not particularly effective. We're using e-mail more and trying to track cell phone numbers, too. (Jim Hardy, senior vice president of care management services for McKesson Health Solutions.)

For more details on improving health and reducing healthcare costs for patients with comorbid conditions, please visit:


The Leading Forum on the Development and Implementation of the Patient-Centered Medical Home

A Hybrid Conference, Internet Event and Training Tool
March 2 - 3, 2009
Hyatt Regency Philadelphia at Penn's Landing
Philadelphia, PA

IBM, UnitedHealthcare and Providers to Collaborate in Arizona PCMH Pilot

UnitedHealthcare and IBM will collaborate with select PCP practices in Arizona to launch a pilot program in the medical home model of care for 7,000 patients. Open to UnitedHealthcare’s employer-sponsored, Medicare Advantage and Medicaid health plan customers, the pilot will include four to six primary care practices from UnitedHealthcare’s physician network in Phoenix and Tucson. The insurer will provide the practices with technology, infrastructure support and care coordination, to enhance patient access to care, the quality and safety of the care experience and patient satisfaction with healthcare providers.

Participating doctors will receive a quarterly management fee for overseeing their patients’ care and will be eligible for bonuses based on quality measures like keeping a patient happy, following established treatment guidelines and being able to avoid hospital stays.

The collaborators expect the PCMH model of care will assist in lowering overall healthcare costs for patients and their employers by reducing ER visits, hospitalizations and disabilities that result from the lack of immediate access to primary care.

For more information, please visit:

Medical Home Monitor Readership Survey

As this newsletter approaches one year of publication, the Healthcare Intelligence Network would like your feedback so we can tailor future issues to your information needs. Please complete this short survey by March 10 and be eligible for a free copy of Simple Steps to a Patient Registry: Ticket to Care Coordination, Quality Reporting and Pay for Performance, a $99 value.

To take the survey, please visit:

HealthSounds Podcast: Medical Home Assignment Empowers Patients

Patient involvement and collaboration with providers are the keys to any successful medical home assignment — so that patients not only understand the benefits and services of the medical home but also how this model of care can empower them, explains Dr. Anita Murcko, medical director of clinical informatics and provider adoption with the Arizona Health Care Cost Containment System (AHCCCS) in this audio interview.

To listen to this complimentary HIN podcast, please visit:

Teaching Med Students Principles of Patient-Centered Care

A new report sponsored by the Josiah Macy, Jr. Foundation recommends that the nation’s medical schools reform their educational model because "it too often fails to give new physicians the right mix of competencies and experiences to practice medicine effectively." Geared toward skills physicians will need in the medical home, "Revisiting the Medical School Educational Mission at a Time of Great Expansion" recommends that medical schools should:

  • Give student more opportunities to learn the principles of quality improvement, patient safety and patient-centered care;
  • Prepare students to work effectively and collaboratively as members of healthcare teams and as part of a system of care;
  • Use community-based settings more as classrooms and hospital settings less, to expose students to a more realistic practice environment;
  • Ensure that physicians have more background in public health education and the role that social factors play in affecting patient health; and
  • Emphasize the importance of problem-solving and self-directed learning as a way to keep up with the fast-paced healthcare environment.
For more information and to download a copy of the report, please visit:

Targeting Depression through Disease Management

Depression is often comorbid with other chronic illnesses. Nearly 6 percent of men and almost 10 percent of women worldwide will experience a depressive episode in any given year, and in America alone, approximately 18.8 million adults suffer from depression. This white paper summarizes the results of a 2008 HIN e-survey in which 250 healthcare professionals shared how their organizations target depression as part of their DM initiatives.

To download this complimentary white paper, please visit:

Save $50 when you register by March 13:

Physician Quality Reporting Initiative in 2009: March 18, 2009 Webinar

Many physician groups are gearing up to participate in year four of the voluntary CMS Physician Quality Reporting Initiative (PQRI). In 2008, CMS awarded more than $36 million in bonus payments to more than 56,700 health professionals who satisfactorily reported quality information to Medicare under the 2007 PQRI process. During Physician Quality Reporting Initiative in 2009, a 90-minute webinar on March 18, 2009, two industry experts will examine the 2009 measures and provide advice on how to overcome submission errors based on an analysis of previous reporting experience.

Reserve your specially priced participation in this webinar today by visiting:

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