Health Policy Center Authors
Publications by Katie Merrell for Health Policy Center
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Realign Physician Payment Incentives in Medicare to Achieve Payment Equity among Specialties, Expand the Supply of Primary Care Physicians, and Improve the Value of Care for Beneficiaries (Research Report)
Stephen Zuckerman, Katie Merrell, Robert A. Berenson, Nicole Cafarella Lallemand, Jonathan Sunshine
This report includes a number of studies related to promoting primary care access, addressing rising health care costs and improving value in the Medicare Physician Fee Schedule. One study showed that alternative methods for allocating Relative Value Units (RVUs) related to practice expenses would not result in a major payment shift to primary care providers. A second study examined the introduction of new codes and the effects of physician productivity changes on the distribution of work RVUs across services. The final study examined approaches promoting primary care services through payment reform, outside of the Medicare Resource Based Relative Value Scale.
Structuring Payment for Medical Homes (Research Report)
Katie Merrell, Robert A. Berenson
Despite widespread interest in the medical home model, there has been a lack of careful assessment of alternative methods to pay practices that serve as medical homes. This paper examines four specific payment approaches: enhanced fee-for-service payments for evaluation and management; additional codes for medical home activities within fee-for-service payments; per patient per month medical home payments to augment fee-for-service visit payments; and risk-adjusted, comprehensive per patient per month payments. Payment policies selected will affect both the adoption of the model and its longer-term evaluation. Evaluations of ongoing demonstrations should focus on payment design as well as on care—and cost.
A House Is Not A Home (Research Report)
Robert A. Berenson, Terry Hammons, David N. Gans, Stephen Zuckerman, Katie Merrell
The "patient-centered medical home" has been promoted as an enhanced model of primary care. Based on a literature review and interviews with practicing physicians, we find that medical home advocates and physicians have somewhat different, although not necessarily inconsistent, expectations of what the medical home should accomplish—from greater responsiveness to the needs of all patients to increased focus on care management for patients with chronic conditions. As the medical home concept is further developed, it will be important to not overemphasize redesign of practices at the expense of patient-centered care, which is the hallmark of excellent primary care.