decisionhealth Newsletters, Part B News - 2008 Issue 12 (December)
CMS will choose 400 practices for medical homes demo
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Article Overview
This article covers a CMS medical homes demonstration project that was scheduled to launch in 2010, including who could participate, how practice sites would be selected, and the general framework for payment and shared savings. It is relevant for physicians, group practices, practice managers, and coding/billing professionals tracking CMS demonstration policy and care coordination initiatives. The article also notes the legislative authority behind the demo and the broad categories CMS used in designing the program.
Why This Topic Matters
The piece provides early operational details for a CMS demonstration that could affect practice participation, reimbursement structure, and care coordination planning. It is useful for stakeholders evaluating whether their specialty, practice setting, or patient mix aligns with a CMS pilot initiative.
Article Sections
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Program overview and site selection
Introduces the medical homes demonstration, its intended launch timeframe, and the number of practice sites and physicians CMS planned to involve. It also summarizes the geographic and practice-setting characteristics CMS said it wanted in participating locations.
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Eligibility and specialty exclusions
Describes the broad provider eligibility framework and identifies categories of specialties that were excluded from participation. The section also references the legislative history behind the demonstration.
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Two payment amounts
Outlines the article’s discussion of the demo’s general payment structure, including a base payment concept and a separate shared-savings component. It also describes the broad factors CMS said would influence the calculation approach.
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Recruitment and application timeline
Notes when CMS planned to begin recruiting practices and the application window for interested participants. The section closes with distribution and participation notes for practices and physicians.
What You Will Learn
- How CMS framed the medical homes demonstration and its planned scope
- What types of practices and locations CMS hoped to include
- Which provider specialties were excluded from the demo
- How CMS described the overall payment framework for participating practices
- When CMS planned to recruit and accept applications
Who Should Read This
- Physicians
- Practice managers
- Medical group administrators
- Coding and billing professionals
- Health policy analysts
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