Executive Update: CMS Demonstration Projects and Government Reimbursement Policies

Table of Contents

1.0 Executive Summary

2.0 Update on the Medicare Reimbursement Policy

• 2.1 Medicare Health Support (MHS) Pilot Program
• 2.2 Medicare Medical Home Demonstration (MMHD) Project
• 2.3 Other Medicare-sponsored Demonstration Projects
  • 2.3.1 Care Management for High-Cost Beneficiaries Demonstration
  • 2.3.2 Medicare Physician Group Practice Demonstration (PGP)
  • 2.3.3 Medicare Senior Risk Reduction Demonstration
• 2.4 Most Recent Legislative Efforts and Policies
• 2.5 Medicare Policy Analysis

3.0 Reimbursement Policy from State Medicaid Programs

• 3.1 State Telemedicine Programs
• 3.2 State Medicaid Policy Trends

4.0 Implications and Recommendations

• 4.1 Medical Device Manufacturers
• 4.2 Health Service Providers

List of Figures

• DM Companies Participating in MHS Project
• Qualifications for Being Recognized as Medical Home Practice
• Reimbursement Rate Determinants for MMHD
• Participating Companies in CMHCBD Project
• State Telemedicine Networks that Cover Store-and-Forward Services
• List of State Medicaid Waiver Programs