The downside of medical homes

Integrated delivery networks (IDNs) and medical homes are all the rage among health wonks.  The ability for patients to receive holistic are from multispecialty practice teams seems like it would be beneficial.  While quality of care may (or may not) improve with more integrated care, provider consolidation may have one downside: higher prices.  An NBER…

A glitch in ACO beneficiary assignement?

For most managed care plans, beneficiaries elect to participate in the plan. In exchange, beneficaries often have lower premiums, but often restricted access to providers (e.g., referral requirements, copayment differentials for out-of-network physicians). Medicare’s Accountable Care Organizations (known as Shared Savings Plans (SSP)) also assign beneficaries to organizations. The SSPs are groups of providers that…

Chronic Care Management: Does it work?

According to one recent study, the answer is ‘yes’. “…mortality is reduced by chronic care management, irrespective of the differences between the studies included. Furthermore, the meta-regression analysis revealed that all-cause hospitalization and the quality of life could significantly be improved by chronic care management. The study quality, the length of follow-up, and the number…

Challenges in Care Coordination

Why is it so difficult to get physicians to work together to coordinate care for their patients?  Here’s why: “The typical primary care physician has 229…other physicians working in 117…practices with which care must be coordinated, equivalent to an additional 99 physicians and 53 practices for every100 Medicare beneficiaries managed by the primary care physician.”…