| Risk Adjustment in the Medical Home: Building an Effective Reimbursement Strategy, a 45-minute webinar on 12/16/09, Recording Available, part of the Medical Home Open House Series, a series of webinars touring the critical components of the medical home. Click here for more information on the series.
Medical home reimbursement models need to take into account the case mix differences in the patient population being treated.
During this 45-minute program, we examined the risk factors that need to be considered in a risk-adjusted medical home reimbursement strategy, from the challenges associated with risk adjustment to strategies for adjusting risk and incentivizing physicians to participate in medical home programs through an attractive risk-adjusted strategy.
The Minnesota Department of Human Services, Minnesotas Medicaid agency, has begun a process to transform healthcare delivery in the primary care setting. Legislation passed in both 2007 and 2005 and a Medicaid Transformation Grant have allowed the state to begin work on the creation of a payment support infrastructure for primary care in the form of risk-adjusted care coordination capitation. The existing model of fee-for-service is being replaced by proactive care planning and management with the patient and families.
The payment methodology takes into account both medical and social/demographic factors associated with medical care coordination. Dr. Jeff Schiff described this methodology and explained how Minnesota addresses the challenges associated with risk adjustment, including
the "year two" problem and the addition of clinical data to the model.
Dr. Schiff covered:
- Alternative payment models and logics;
- Risk adjustment principles; and
- Methodologies developed and being considered for payment risk adjustment.
Presenter: Jeff Schiff, MD, MBA, Medical Director, Minnesota Health Care Programs, Minnesota Department of Human Services
Listen to Jeff Schiff's pre-session comments:
There's a business case for putting patients at the care planning table.
Available on the HIN web site for an on-demand re-broadcast or as a CD-ROM or training DVD.
The training DVD includes reproducible slides and completion certificates to document training.
You can listen to this program right in your office and enjoy significant savings – no travel time or hassle; no hotel expenses. It’s so convenient! Invite your staff members to gather around a conference table to listen to the CD, training DVD or the On Demand version.