Goals

Our goal is to recognize the added value provided to patients who have a patient-centered medical home. The incentive structure should be based on the following framework:

• It should reflect the value of physician and non-physician staff patient-centered care management work that falls outside of the face-to-face visit.

• It should pay for services associated with coordination of care both within a given practice and between consultants, ancillary providers, and community resources.

• It should support adoption and use of health information technology for quality improvement.

• It should support provision of enhanced communication access such as secure e-mail and telephone consultation.

• It should recognize the value of physician work associated with remote monitoring of clinical data using technology.

• It should allow for separate fee-for-service payments for face-to-face visits. (Payments for care management services that fall outside of the face-to-face visit, as described above, should not result in a reduction in the payments for face-to-face visits).

• It should recognize case mix differences in the patient population being treated within the practice.

• It should allow physicians to share in savings from reduced hospitalizations associated with physician-guided care management in the office setting.

• It should allow for additional payments for achieving measurable and continuous quality improvements.