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Patient-Centered Medical Home Demonstration Projects

The Centers for Medicare and Medicaid Services (CMS) is currently accepting applications from states through August 3, 2010 for Multi-payer Advanced Primary Care Practice Demonstrations (MAPCP), also known as patient-centered medical homes (PCMH). Demonstrations are aimed at improving care coordination and quality outcomes, in addition to developing and implementing multi-payer reform initiatives. These projects have been touted as a model for addressing flaws in the health care delivery system, such as quantity versus quality. Efforts align with President Obama's health care reform overhaul and will be spearheaded by state Medicaid agencies and/or health departments. Other stakeholders include private health plans, self-insured employer-sponsored health plans, and eventually Medicare.

Some states and localities have already been working on home health pilot projects and have the opportunity to submit an application to participate and expand their current efforts. For example, Vermont's Blueprint Integrated Pilot Program, which has been in place for several years, is aimed at chronic care management and prevention. In May 2010, Harvard Medical School evaluated 26 existing demonstration projects and found many had adopted a three-part payment model: Fee-for-service payments, a fixed, monthly case management fee, and potential bonuses based on clinical performance. Other findings included substantial diversity in the pilots' design and a lack of evaluation plans in several projects. The CMS MAPCP program requires an evaluation plan to monitor performance and gather feedback from participating groups to understand the impact on utilization, expenditures, access to care, and the quality of care.

GovWin's Take:

The demonstration projects will provide an opportunity to initiate advanced health care reform at the state level. Vendors will serve as valuable partners in evaluating and monitoring programs. In addition, health IT systems will play a crucial role in facilitating care coordination, timeliness, and improved patient-provider communication. Vendors providing health IT solutions should work closely with stakeholders to understand end-goals and objectives to ensure system flexibility.

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