The letter correctly points out that, while it was going to be difficult for small physician owned practices to participate at a Level I or II, it will be far more difficult for these clinics to attain the highest NCQA Tier III level. It takes considerable resources to attain this, and the inevitable failure to do so will effectively shut out about 1/2 of all the U.S. primary care physicians from participation. As a result, we will have no idea if the the Medical Home is a viable and generalizable option in fee for service Medicare in all corners of the country.
What are they thinking?
You're welcome to sign onto the letter to express your concern. Readers can contact Relja Ugrinic, at firstname.lastname@example.org, directly by COB Tuesday, April 21st, to add your name to the letter.