I don't get it. Why does the "medical home" concept seems so exciting? The American Academy of Family Physicians is pushing this hard as they try to re-brand our profession. Here is an article in the American Medical News with the title Medical homes get boost in Louisiana Medicaid reform effort. It goes on to say that the model could help Medicaid provide better value to patients with low incomes or disabilities. Is that what the "medical home" does? It gets to oversee Medicaid patients? I think you will find that the "medical home" concept will be hijacked and manipulated in many ways in the future. States and managed care organizations will twist it the way they want to and then use it to pay a smidgen of a bonus to some while penalizing others.
The only ones who will profit from the "medical home" idea are the entrepreneurs who will start a business that claims to certify whether your office is a "medical home" or not. You see these people all the time. They are former medical personnel who get the blessing from the government or third-party payers to come into your office and judge you. They may look at your EMR, customer service, patient safety, etc. They do this because the government doesn't have the time or the resources. It just adds more bureaucratic layers to the decaying onion we call our healthcare system.
The hell with it. I am going to start a new business myself. Why shouldn't I become one of these certifying agents? I will call my organization the Medical Home Certification Qualifier or MHCQ. For a price I will come into your office, if you are a primary care doctor, and rank you in certain areas that I make up. Of course, I will convince managed care and CMS that I am on the up and up. Depending on how well you do, you will be given a rank of one of the following:
- medical home (best)
- medical condo
- medical apartment
- medical shanty
- medically homeless (worst)
Who wants to join me in this venture? If you think this is a joke (it is, but not in the way you think) then wait a year and see how many new businesses will be doing this. You heard it here first. Nostradougus has spoken again.
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