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Medical Home Evaluations - Why They Fail, How to Structure Them

Wednesday, May 26, 2010
1:00 pm - 2:00 pm (Eastern)
12:00 pm - 1:00 pm (Central)
11:00 am - 12:00 pm (Mountain)
10:00 am - 11:00 am (Pacific)


Raymond Carter
Editor, Medical Home News, Modesto, CA (Moderator)

Debbie Peikes, MPA, PhD
Senior Researcher, Mathematica Policy Research, Visiting Lecturer, Woodrow Wilson School, Princeton University, Princeton, NJ


The Patient-Centered Medical Home is one of the hottest concepts in health care today. Many would say it is foundational to a proper health care reform agenda of improving patient engagement, care coordination, and quality, especially for patients with chronic conditions, while at the same time "bending the cost curve" by reducing unnecessary emergency department visits, hospitalizations, and medical errors. Medical home pilots and initiatives abound, from solo practices officially recognized by NCQA to statewide multi-payor initiatives with Medicaid and commercial health plan participation. Blogger Vince Kuraitis counted five pilots and 30 demonstration programs in the Patient Protection and Affordable Care Act that were specific to, or related to, the Patient-Centered Medical Home, and in an op ed in the April 2010 issue of Medical Home News, warned of the medical home "drowning in an ocean of opportunity."

But how much do we really know about the ingredients for success in a medical home? Or about which of its many moving parts are the key drivers behind better outcomes? The swift collapse of the disease management demonstrations, all of which looked promising and some of which had even guaranteed savings, suggests that the medical home movement should proceed with careful attention to a rigorous research and evaluation agenda. Debbie Peikes, Senior Researcher at Mathematica Policy Research and Visiting Lecturer in the Woodrow Wilson School at Princeton University, will walk attendees through the thicket of evaluation do's and don'ts, including with his permission the detailed critique of the Community Care of North Carolina medical home evaluation that Al Lewis performed.

Dr. Peikes is currently working with AHRQ to develop a series of white papers on the medical home, describe the medical home landscape in the literature and on the web, facilitate collaboration among the various federal players, and suggest areas where further investments are needed. She helped CMS design the now on-hold Medicare Medical Home Demonstration, and currently she advises UnitedHealth on designing and evaluating their medical home initiatives. In this audioconference, Dr. Peikes will assess the lessons from disease management, the current state of medical home evaluations, and why some evaluations will fail and some succeed.

The Audioconference agenda is set forth in Eastern Daylight Time below:
1:00 pm Welcome, Introductions, and Overview
Raymond Carter (Moderator)
1:05 pm Medical Home Evaluations - Why They Fail, How to Structure Them
Debbie Peikes
1:45 pm Panel Questions and Answers
Raymond Carter (Moderator)
2:00 pm Audioconference Adjournment



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JUNE 30, 2010
What if a Health System Decided to Create "Ideal" Primary Care?
Principal faculty: Joseph E. Scherger, MD, MPH, Vice President for Primary Care, Eisenhower Medical Center and Clinical Professor, Family Medicine, University of California, San Diego Rancho Mirage, CA
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