Dr. Arlene Ash presents to CMS on new risk-adjustment payment model for Patient Centered Medical Homes

Dr Arlene Ash, Chief of the Division of Biostatistics and Health Services Research in the Department of Quantitative Health Sciences and a national leader in risk adjustment, was invited by the Center for Medicare and Medicaid Services (CMS) to describe an exciting new payment model for Patient Centered Medical Homes that she and Dr. Randall Ellis  (Department of Economics, Boston University) have developed and preliminarily tested.

In their talk, Payment Reform in Support of Practice Reform, at CMS on February 15, 2011, they provided detail on a comprehensive payment system for primary care to replace fee-for service reimbursement.  Their system provides for risk-adjusted (that is, health-based) partial capitation and performance-based bonus payments.  they reported that early pilot data suggests that Medicare's support for PCMH transformation could be self-financing, even in the fairly near term.