CMS selects 500 FQHCs for Advanced Primary Care Practice demonstration project

Posted on October 24, 2011 | Comment (1)
Filed under Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Department of Health and Human Services, Disparities, Health Care Quality and Delivery System Reform, Health Resources & Services Administration, Key Developments, Medicaid and CHIP, Uncategorized

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The Centers for Medicare and Medicaid Services (CMS) announced today that 500 Federally Qualified Health Centers (FQHCs) have been selected to participate in the Advanced Primary Care Practice demonstration project. These 500 centers will receive $42 million over three years to improve quality and coordination of health care delivery. The project is designed to evaluate the patient-centered medical home model. The goal of the model is to improve patient health and the quality of health care delivery while lowering the cost of of care. HRSA and the Center for Medicare and Medicaid Innovation Center developed the demonstration, which will be conducted from November 1, 2011 through October 31, 2014.

Comment (1)

William E Tierney, CPA says:

May 14, 2012 at 8:52 pm

Productivity screenings-Team & Non-Team

Make sure the Medicaid model uses the team productivity standard, and not the non-team productivity standard. With the non-team productivity standard, a patient may never see a physician; they could be seen by midlevels only. The Medicaid non-team productivity standards are not a reasonable screening process.
The Medicaid productivity screening is using the higher count of actual encounters, or standard encounters (4200 for docs & 2100 for midlevels) for each provider type.

Medicare uses the higher of actual team encounters, or team standard encounters. Medicare is using the reasonable productivity screen.

The Medicaid programs created the non-team standard after a 1994 Medicare printing error on the Medicare HCFA/CMS 222 productivity form. It must have been published at one of the State Medicaid director meetings. I would really like to find a presentation document.

It is time for someone to step up and show how bad the non-team productivity standards methodology is.

Let’s look at the productivity for 500 Health Center base PPS rates & actual encounter productivity using both methods.

Did Medicaid apply productivity penalties when the FQHCs actually met team productivity standards?

These 500 FQHCs would be a great case study.

The form HCFA -222-92 (8/94) Worksheet B, Part I & II Line 1-3, col. 4 were not shaded, thereby causing the Non-Team practice of medicine in the USA FQHCs. The Medicare intermediary recorded the XXXX where it should have been shaded The Medicare computerized Form HCFA/CMS 222 was always correct.

After 18 years, Medicaid now needs to use the more reasonable screening model.
We now need to use the proper national productivity screening philosophy.

TEAM-TEAM-TEAM-TEAM-TEAM-TEAM

The 2012 MEI % change from 1.8% to 0.60%; I know I did the right thing.

WET

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