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This concise overview explores the evolution of patient-centered medical homes (PCMH) and their role in shaping the future of healthcare reimbursement. Key models discussed include traditional Fee-for-Service (FFS) with new discrete codes, enhanced payment levels, supplemental lump sum payments, and a variety of per-member-per-month (PMPM) payment structures. The paper also examines comprehensive payment models that integrate performance-based measures. Resources for further reading include major health policy organizations and collaborative initiatives focused on advancing primary care.
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The Models for Reimbursement • FFS with discrete new codes • FFS with higher payment levels • FFS with supplemental lump sum payments • FFS with PMPM fee • FFS with PMPM fee and with P4P • FFS with PMPY payment • Comprehensive Payment with P4P Adapted from Michael Bailet
Reference Sites National Academy for State Health Policy: http://www.nashp.org/ Patient Centered Primary Care Collaborative: http://www.pcpcc.net/ or www.patientcenteredprimarycare.org The Commonwealth Fund: http://www.commonwealthfund.org/programs/programs_list.htm?attrib_id=11932
