Author: Lumeris

It might be a move in the right direction, or it could be a significant change in how the physician fee schedule encourages certain types of care—we won’t know until later—but right now it’s encouraging that CMS is considering paying primary care physicians for chronic care management services without an in-person visit, and also for telehealth services. “I think primary care physicians are going to see a tsunami of patients wanting care and newly insured in 2014, and this is one of the easier ways to expand capacity,” said Tom Doerr, MD. “You don’t have to take on the hiring of a new midlevel clinician. There is a lot less stress involved with just sending an email and getting reimbursed for it.”

In my role at Lumeris I often get asked by our clients, “What does care management really mean?” For me, having spent decades practicing geriatric medicine and teaching the principles of post-acute care coordination at a private research university and medical center, care management can be defined, most completely, as better care at lower cost for people with multiple health and social needs.

The rumors are starting to be heard and the rumblings are starting to be felt. Will there be major financial fallout under accountable care and specifically CMS’s regulatory ACO programs?

Quickly out of the gate for 2013, Health Affairs featured the theme of Transforming the Delivery of Health Care in its January edition, Arnold Milstein MD’s Code Red & Blue – Safely Limiting Health Care’s GDP Footprint headlined the New England Journal of Medicine, and CMS announced a new wave of 106 additional ACOs to their program.