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Maine Multi-Payer Pilot Patient Centered Medical Home Model. A Collaborative Effort of the Maine Quality Forum, Quality Counts, & the Maine Health Management Coalition. Lisa M. Letourneau MD, MPH. November 2008. Objectives.
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Patient Centered Medical Home Model
A Collaborative Effort of
the Maine Quality Forum, Quality Counts, & the Maine Health Management Coalition
Lisa M. Letourneau MD, MPH
More (and more) U.S. health care spending…
Why Not the Best? Results from the National Scorecard on U.S. Health System Performance 2008, Commonwealth Fund
More primary care services are associated with better outcomes
*Rank based on patient satisfaction, expenditures per person, 14 health indicators, and medications per person in Australia, Belgium, Canada, Denmark, Finland, Germany, Netherlands, Spain, Sweden, United Kingdom, United States
“The provision of integrated, accessible health care services by clinicians who are accountable for addressing the large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.”
Institute of Medicine: Primary Care: America’s Health in a New Era, Washington DC: National Academy Press, 1996
The 15 minute visit!
Employers & payers unwilling to pay for desired services unless primary care demonstrates value AND create potential to save money
Providers unable to transform practice without viable & sustainable payment for desired services
Providers transform practice, create value with viable & sustainable payment for desired services
= Practice Transformation
Employers & payers pay for desired services because primary care demonstrates value AND saves money
= Payment Reform
PCMH recognizes need, supports BOTH…
“A medical home is not a building, house, or hospital, but rather an approach to providing comprehensive primary care. A medical home is defined as primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective.”
American Academy Pediatrics
Multi-Payer pilot discussions/activity
Identified pilot activity
No identified pilot activity
Maine Quality Forum
Maine Health Management Coalition
PCMH Working Group – work to date:
PCMH Working Group – work in progress…
6. More fully identify outcome measures, evaluation plan
7. Dev plan for supporting practice transformation
8. Conduct outreach, communication to key stakeholders, including all PCP practices
9. Identify additional resources to support implementation
MHMC-convened Physician Payment Reform Comm
With thanks to Dr. Tom Bodenheimer, Dept. Family & Community Med, UCSF