Reforming the primary care physician payment system: Eliminating e & M codes and creating the financial incentives for an "advanced medical homeg"

Journal of Ambulatory Care Management

Volumn 31, Issue 1, 2008, Pages 24-31

  Goldfield, Norbert ^a,f   Averill, Richard ^a   Vertrees, James ^a   Fuller, Richard ^a   Mesches, David ^a,b   Moore, Gordon ^a,c   Wasson, John H ^a,d   Kelly, William ^a,e  

^a 3M COMPANY   (United States)

^b Family Practice Institute   (United States)

^c UNIVERSITY OF ROCHESTER   (United States)

^d DARTMOUTH MEDICAL SCHOOL   (United States)

^e Treo Solutions   (United States)

^f Health Information Systems   (United States)

Author keywords

Comprehensive payment; Fee for service; Medical home; Primary care; Resource based relative value scale

Indexed keywords

ARTICLE; ECONOMICS; GENERAL PRACTITIONER; HEALTH CARE POLICY; MEDICAL FEE; MEDICAL INFORMATION SYSTEM; MEDICAL RECORD; MEDICARE; ORGANIZATION AND MANAGEMENT; REIMBURSEMENT; RISK MANAGEMENT; UNITED STATES;

CURRENT PROCEDURAL TERMINOLOGY; FEE-FOR-SERVICE PLANS; FORMS AND RECORDS CONTROL; HEALTH CARE REFORM; INSURANCE, HEALTH, REIMBURSEMENT; MEDICARE; PHYSICIANS, FAMILY; REIMBURSEMENT MECHANISMS; REIMBURSEMENT, INCENTIVE; RISK SHARING, FINANCIAL; UNITED STATES;

EID: 37749040320     PISSN: 01489917     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.JAC.0000304093.05840.e2     Document Type: Article

References (8)

1. Averill, R., Goldfield, N., Wynn, M., McGuire, T., Mullin, R., Gregg, L., et al. (1993). Design of a prospective payment classification system for ambulatory care. Health Care Financing Review, 15(1), 71-100.
2. Barr, M., & Ginsburg, J. (2006). The advanced medical home: A patient-centered, physician-guided model of health care. Philadelphia, PA: American College of Physicians.
3. Goldfield, N., Averill, R., Grant, T., &Gregg, L. (1997). The clinical development of an ambulatory classification system: Version 2.0 Ambulatory Patient Groups. Journal of Ambulatory Care Management, 20(3), 49-56.
4. Goroll, A. H., Berenson, R. A., Schoenbaum, S. C., & Gardner, L. B. (2007). Fundamental reform of payment for adult primary care: Comprehensive payment for comprehensive care. Journal of General Internal Medicine, 22, 410-415.
5. Hughes, J., Averill, R., Eisenhandler, J., Goldfield, N., Muldoon, J., Neff, J., et al. (2004). Clinical risk groups, a classification system for risk-adjusted capitation-based payment and health care management. Medical Care, 42(1), 81-90.
6. Maxwell, S., Zuckerman, S., & Berenson, R. (2007). Use of physician's services under medicare's resource-based payments. New England Journal of Medicine, .356(18), 1853-1861.
7. Vertrees, J., Pollatsek, J., Sheets, K., & Stark, M. (1994). Developing an outpatient prospective payment system based on APGs for the Iowa medicaid program. Journal of Ambulatory Care Management, 17(4), 82-96.
8. Winkelman, R., & Syed, M. (2007). A comparative analysis of claims-based tools for health risk assessment. Retrieved September 27, 2007, from http://www.soa.org/files/pdf/risk-assessmentc.pdf