Journal Articles

• A national symposium on the patient-centered medical home brought together experts in primary care, health services and implementation research, health systems and insurance, as well as policymakers to develop a research agenda. The commissioned papers, reflecting discussions at the conference, are in the June issue (subscription required) of the Journal of General Internal Medicine:
  
  "Using Evidence to Inform Policy: Developing a Policy-Relevant Research Agenda for the Patient-Centered Medical Home." Bruce Landon, James Gill, Richard Antonelli, and Eugene Rich. This paper summarizes the symposium.
  
  "U.S. Approaches to Physician Payment: The Deconstruction of Primary Care." Robert Berenson and Eugene Rich. This paper addresses why the three dominant alternatives to compensating physicians (fee-for-service, capitation, and salary) fall short of what is needed to support enhanced primary care in the patient-centered medical home and the relevance of payment reforms, such as pay-for-performance and episodes/bundling.
  
  "How to Buy a Medical Home? Policy Options and Practical Questions." Robert Berenson and Eugene Rich. This paper describes payment options to support the patient-centered medical home and identifies conceptual strengths and weaknesses.
• "Prospects for Rebuilding Primary Care Using the Patient-Centered Medical Home." Bruce Landon, James Gill, Richard Antonelli, and Eugene Rich, Health Affairs (subscription required), May 2010. This article analyzes potential barriers in the U.S. to the patient-centered medical home model, which is considered policy shorthand for the reinvention of primary care. Barriers include developing new payment models, personnel and infrastructure funding, and methods to facilitate transforming existing practices to functioning medical homes.

Issue Briefs

• "Politics and Policy of Comparative Effectiveness: Looking Back, Looking Ahead." Topics in Health Care Effectiveness #1. Eugene C. Rich and Elizabeth Docteur, June 2010. Interest in evaluating which health care interventions work best under what circumstances has surged in recent years as health care spending has risen. This brief, the first from Mathematica’s Center on Health Care Effectiveness, looks at the new comparative effectiveness research (CER) initiative passed as part of health care reform. Rich and Docteur discuss  the status of four ongoing policy challenges relevant to the successful implementation of CER:  funding mechanism, how the research gets used, how the CER enterprise is directed, and  perhaps most fundamentally, the proper scope of CER.  They note important questions remain whose resolution may prove critical to the future role of this research in U.S. health care.