The Other Medical Home

Landers talks about Medicare payment reforms. The Medicare Payment Advisory Commission (MedPAC) recently provided a set of recommendations for Medicare payment reforms. A key piece of this reform agenda is pilot testing a payment for a "Medical Home," a concept that creates a way for primary care clinicians to receive payment for added care coordination, care integration, quality improvement, and education activities for patients with chronic diseases. The extra payments would be accompanied by added requirements and accountability for outcomes. However, the Medical Home initiative, as currently articulated, ironically fails to emphasize the complex chronically ill patient's actual home.