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The proposed rule for the Medicare Shared Savings Program provides an initial roadmap for how providers could be reimbursed by Medicare as accountable care organizations (ACOs). Reading the rule from a medical home perspective, we see strong reinforcement of the importance of the medical home model in achieving shared savings goals. The rule also points the way toward future direction of PCMH model evolution--for example, by updating and expanding the CMS definition of "patient-centeredness" and laying out some objectives that even the most advanced PCMHs will have to stretch to meet.
New Shared Savings Rule: PCMH Implications
Harvard Medical School has announced a $30 million initiative to transform primary care education and training through the creation of the Center for Primary Care. The Center puts Harvard Medical School at the forefront of an emerging trend across academic medical centers (AMCs). Taking stock of the state of primary care, many AMCs are working to address shortfalls between their status quo configuration and what would most likely be needed to function as an accountable care organization (ACO).
Sign of the Times for AMCs: Harvard's Primary Care Center
Hospitals struggle with the issue of how to support independent practices in the PCMH model without running afoul of the law. From the viewpoint of Squire, Sanders & Dempsey L.L.P. attorneys John Kirsner and John Wyand, the essential starting point is letting go of the idea that it is OK to provide significant operational support to physician practices "for free" under the banner of quality improvement.
Attorney interview: The "Primary Care Institute" as a contractual framework for hospital-physician PCMH support