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:
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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.
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It should pay for services associated with coordination of care both within a given practice and between consultants, ancillary providers, and community resources.
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It should support adoption and use of health information technology for quality improvement.
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It should support provision of enhanced communication access such as secure e-mail and telephone consultation.
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It should recognize the value of physician work associated with remote monitoring of clinical data using technology.
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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).
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It should recognize case mix differences in the patient population being treated within the practice.
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It should allow physicians to share in savings from reduced hospitalizations associated with physician-guided care management in the office setting.
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It should allow for additional payments for achieving measurable and continuous quality improvements.