Quicker incentives needed for medical home coordination

Despite hope resting on the concept of the patient-centered medical home, widespread patient access to such care remains a far-off reality, prompting the American Medical Association (AMA) to push for more immediate physician incentives to improve coordination of care.

According to a new study led by the University of Michigan Health System, nearly half (46%) of physician practices do not meet national standards to qualify as a medical home. What's more, researchers found that larger, multispecialty groups have a greater potential for meeting medical home standards such as those outlined by the National Committee on Quality Assurance (NCQA); however, nine out of 10 Americans receive healthcare from physicians who practice in smaller, single-specialty groups.

True medical homes also are rarer in lower-income communities with the most vulnerable patient populations, the team found. Thus, Dr. John Hollingsworth and the coauthors urged policy makers "to address the challenges facing smaller practices" to "make the benefits of medical homes more equitable and widely accessible."

The AMA agrees, with its Specialty Society Relative Value Scale Update Committee (RUC) having recently told the Centers for Medicare & Medicaid Services (CMS) that physicians shouldn't have to wait for medical homes to take hold before being reimbursed more to coordinate patients' care. As part of its recommendation to CMS, the RUC wants to see physicians next year paid for several care coordination codes, such as those for patient training and telephone services, that are already in existence but currently not reimbursed on top of E/M services.

"These are short-term fixes, but they recognize the value of work done outside the face-to-face visit, which has not been properly paid for," Dr. Lori Heim, who chairs the primary care payment valuation task force of the American Academy of Family Physicians, told Medscape Medical News. "[The RUC proposal] could be a real game-changer."

To learn more:
- see the press release from the RWJF Clinical Scholars program
- check out the abstract from the journal Health Services Research
- read the article from Medscape Today

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