decisionhealth Newsletters, Part B News - 2016 Issue 10 (October)
Scoring boost, value-based dollars back up the medical home model
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Article Overview
This article reviews Medicare’s Quality Payment Program as it relates to patient-centered medical homes and why the policy matters for practices considering or operating under a medical home model. It covers the general framework for quality scoring, the alternative payment model track, and the expanded approach to recognizing medical home accreditation or certification. The piece is aimed at clinicians, practice leaders, and coding or reimbursement professionals tracking value-based payment policy.
Why This Topic Matters
Understanding how the Quality Payment Program treats medical homes can affect practice strategy, recognition decisions, and participation in value-based payment programs. The article helps readers assess whether the medical home model may improve scoring opportunities or support advanced payment model status.
Article Sections
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Quality Payment Program overview
Introduces the Medicare payment framework and its relevance to patient-centered medical homes. Summarizes the article’s focus on scoring and payment implications.
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Medical homes receive automatic max scores
Describes how medical homes are treated within the quality-reporting structure under the current payment model. Discusses the broader significance of this treatment for practices considering the model.
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Charting a path to advanced payment models
Explains the article’s discussion of the alternative payment model track and the general considerations tied to advanced status. Covers the way the rule addresses medical homes as a distinct category.
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CMS takes inclusive approach to PCMH models
Summarizes the expanded recognition approach for patient-centered medical homes and the role of certifying or accrediting organizations. Notes that the article includes examples of recognized programs and related resources.
What You Will Learn
- How the Quality Payment Program relates to patient-centered medical homes
- What general types of scoring treatment are associated with medical homes
- How the article frames alternative payment model considerations for medical homes
- How medical home recognition pathways were broadened under the policy discussed
- Which organizations and programs are referenced in connection with medical home accreditation and certification
Who Should Read This
- Primary care clinicians
- Practice administrators
- Revenue cycle and reimbursement professionals
- Medical coding and compliance staff
- Value-based care policymakers
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