The patient-centered medical home has been actively promoted by the AAFP. The Veterans Affairs department is the only federal agency that supports a medical home model.
The ACP is proposing that Medicare provide physicians with a “bundled,” prospective, per-patient payment for serving as the locus of all care. One component would cover practice overhead; another element would cover coordination of care, including paperwork, and telephone and e-mail conversations with other treating physicians and family members. Face-to-face visits would be covered by a fee-for-service component. There also would be a pay-for-performance element, based on outcomes.
Only physician practices that have met the medical home criteria—such as having the ability to track patients and communicate with them electronically—would be eligible for the bundled payment, said Dr. Kirk, associate chief of the University of Texas Southwestern Medical School's general internal medicine division. The criteria are still being developed, said Robert Doherty, ACP's senior vice president for governmental affairs and public policy.
Practices that do not fulfill the criteria would be able to receive separate payments for specific care coordination services, Mr. Doherty told reporters.