Center Call Agenda, Tuesday July 7th, 3:00PM EST

Center to Promote Public Payer Implementation
Tuesday, July 7th, 2009
3:00pm-4:00pm, EST
Call in number: 712.432.3900   Code -  471334#    Moderator/Speakers - *406354

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Call Agenda

Comparative Effectiveness and PCMH
PCMH and Community Teams
Health Reform Congressional Update

I. Introductions

• Compare the effectiveness of comprehensive care coordination programs, such as the medical home, and usual care in managing children and adults with severe chronic disease, especially in populations with known health disparities.
• Compare the effectiveness of various strategies (e.g., clinical interventions, selected social interventions [such as improving the built environment in communities and making healthy foods more available], combined
  clinical and social interventions) to prevent obesity, hypertension, diabetes, and heart disease in at-risk populations such as the urban poor and American Indians.
• Compare the effectiveness of interventions (e.g., community-based multi-level interventions, simple health education, usual care) to reduce health disparities in cardiovascular disease, diabetes, cancer, musculoskeletal diseases, and birth outcomes.
• Compare the effectiveness of literacy-sensitive disease management programs and usual care in reducing disparities in children and adults with low literacy and chronic disease (e.g., heart disease).
• Compare the effectiveness of clinical interventions (e.g., prenatal care, nutritional counseling, smoking cessation, substance abuse treatment, and combinations of these interventions) to reduce incidences of infant mortality, pre-term births, and low birth rates, especially among African American women. 
   

A. House Activity

The House Tri-Committee Health Reform Draft

On June 19, 2009 the Chairmen of the three committees with jurisdiction over health policy in the U.S. House of Representatives unveiled their discussion draft for health care reform.  The draft would reduce out-of-control costs, improve choices and competition for consumers and expand access to quality, affordable health care for all Americans.
Included in this draft is language on the Patient Centered Medical Home (PCMH).  The draft bill includes funding of $350 million for PCMH pilot programs, which include Independent PCMHs and Community-based Medical Homes.
'The Secretary shall establish a medical home pilot program (in this section referred to as the ‘pilot program’) for the purpose of evaluating the feasibility and advisability of reimbursing qualified patient-centered medical homes for furnishing medical home services (as defined under subsection (b)(2)) to high need beneficiaries (as defined in subsection (b)(1)).' 

B. Senate Activity

The Senate HELP Committee released the ‘Affordable Health Choices Act’ on June 9, 2009 outlining the committee’s option for health care reform.
 
Section 212 of the draft legislation - ‘Grants to Establish Community Health Teams to Support a Medical Home Model’ stated that:
"The Secretary of HHS would establish a grant program to creating the “community health team which is community-based, multi disciplinary, interprofessional teams (on the model of medical home) to increase access to comprehensive coordinated care."

Enhancing Health Care Workforce Education and Training - There is language in the bill also aimed to enhance health care workforce education and training in Family Medicine, General Internal Medicine, General Pediatrics, and Physician Assistantship by providing grants to develop and operate training programs, financial assistance of trainees and faculty, and faculty development in primary care and physician assistant programs. This bill would provide grants to establish, maintain and improve academic units in primary care. Priority is given to programs that educate students in team-based approaches to care, including the patient-centered medical home. Authorization is set at $125 million.

The Senate Finance Committee is working on its own health care reform legislation.  Their focus on primary care and the medical home model includes:

• Primary Care Bonus Payment - Certain Medicare providers being eligible for a primary care services bonus payment of at least 5 percent over the fee schedule amount for providing certain evaluation and management services.
• Chronic Care Management Innovation Center (CMIC) - The establishment of the CMIC at CMS for Medicare by the Secretary of HHS for the purpose of testing and disseminating payment innovations that foster patient-centered care coordination, with advancing PCMHs at the top of their list.
  Potential Items- The Committee would also look to reimburse states that use the PCMH model in their Medicaid programs.

IV. Review and Update Deliverables

V. Wrap-up and Next Agenda

Next call (Federal Programs Working Group) is: Tuesday September 8th, 2009; 3:00 PM EST

Resources
Center to Promote Public Payer Implementation Website
http://www.pcpcc.net/content/center-promote-public-payer-implementation

Purchasers Guide: http://www.pcpcc.net/content/purchaser-guide
Pilot Guide: http://www.pcpcc.net/content/pcpcc-pilot-projects
 

Deliverables' Timeframe