An Evolving Health Reform Landscape – Part 2 of 4

by Mark A. Ridenour of the Ridenour Group, Consultant to the Ohio Optometric Association

Primary care practices are moving to a Medical Home model. The medical home aims to replace the current episodic sick care model with one that employs a team of health care providers, led by the physician, to engage the patient in an ongoing relationship toward optimizing personal health and coordinating all care.  Access is enhanced by open scheduling, expanded hours, and communication options other than face-to-face.  The most common term used is the Patient-Centered Medical Home (PCMH) which is accredited by NCQA and others.  Accreditation is a requirement for most insurers to enable enhanced reimbursement.

The transformation of Primary Care practices to PCMH has increased exponentially across the country with robust development where additional state and federal level support is present.  There are now nearly 200 accredited PCMHs across Ohio, for example, with others in the pipeline aided by state funds targeted to assist practices in making this transformation.  Ohio has been recognized as a leader in PCMH with the Cincinnati/Dayton region selected as one of seven in the country where Medicare, under the CMS Innovation Center’s  Comprehensive Primary Care Initiative (CPCi), is joining nine other payers in support of a four year pilot expected to yield $15M from Medicare for 75 practices over the next four years.  Another government initiated model, Health Homes, is a Medicaid version focused on mental health and those with multiple chronic conditions.

“An Evolving Health Reform Landscape” is a four-part series.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s