1. Building Model Homes in the Changing Medical Neighborhood
Seaton Hall Symposium October 28, 2011
Sallie Thieme Sanford
Assistant Professor
University of Washington School of Law

2. Expanded Interest in Patient-Centered Medical Homes
Enhanced primary care model
Idea dates back to 1960’s
2007 joint principles
Comprehensive
Coordinated
Patient-Centered
Accountability
Payment Reform

3. PCMHs, ACOs and Delivery System Reform
“not far removed in principle from the ACO” Furrow et. al.
“the medical home needs a hospitable and high-performing medical neighborhood” Fisher
Promoted in ACA
Private sector
Various pilots

4. The States’ Roles in PCMH Development
Lots of interest Medicaid Multi-payer Convener Studies Grants ACO linkages

5. Washington State’s Multi-Payer Medical Home Pilot
Authorizing legislation
Multi-payer (seven major insurers)
Multi-site (twelve practice sites)
Up-front payments (hybrid model)

6. Washington State’s Multi-Payer Medical Home Pilot
Shared savings payments
Down-side risk
Preventable ER visits, hospitalization
Quality measures

7. Is there no place like home? Issues, Comments, Questions
How will they evolve?
Truly transformative?
Will savings offset payments?
Coordination or conflict?