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Summary

Recent health policy initiatives designed to improve care coordination have stimulated the resurgence of the patient-centered medical home (PCMH) model. The details of how primary and specialty care are coordinated within the PCMH model are of interest to specialists. A good medical home “neighbor” must adhere to principles that complement the PCMH team-based approach and personal relationship to the patient. One issue for neurologists considering participation in this model is whether they will function as the principal physician for some patients, only in the role of a consultant, or take some new role. It is too early to suggest any one payment method as superior, or establish the appropriate capitation fees for practicing neurologists. Recommendations are provided for neurologists considering participation in a PCMH neighborhood.

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Information & Authors

Information

Published In

Neurology® Clinical Practice
Volume 3Number 2April 2013
Pages: 134-140

Publication History

Published in print: April 2013
Published online: April 15, 2013

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Disclosures

D. Hoch has received honoraria for teaching at AAN courses and his wife owns stock in Express Scripts Holding Co., a medical services company. M. Homonoff and H. Moawad report no disclosures. B. Cohen has received honoraria for teaching at AAN courses, is a consultant to Health and Human Services for the Vaccine Compensation Program, receives travel funds for organizing clinical trials from Edison Pharmaceuticals, and has been on the speaker's bureau for Transgenomic (ending 12/31/2010). G. Esper has received honoraria for teaching at AAN courses and remuneration for legal consultation with Maglio, Christopher, and Toales Law firm. A. Becker is a full-time employee of the AAN. N. Busis has received honoraria for teaching at AAN courses. Go to Neurology.org/cp for full disclosures.

Study Funding

No targeted funding reported.

Authors

Affiliations & Disclosures

Daniel B. Hoch, MD, PhD
Massachusetts General Hospital (DBH), Boston; Beth Israel Hospital and Mt. Sinai School of Medicine (MCH), New York, NY; Children's Hospital Medical Center of Akron (HM, BHC), Akron, OH; Emory University (GJE), Atlanta, GA; American Academy of Neurology (AB), Minneapolis, MN; and UPMC Shadyside (NAB), Pittsburgh, PA.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
AAN.COM, Associate Editor, 2008-2012, Proto Magazine (www.protomag.com) Editorial Advisory Board, 2009-present Journal of Participatory Medicine, Editorial Board, 2008- present.
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Sunovion. Efficacy and safety of Eslicarbazepine Acetate (BIA 2-093) as adjunctive therapy for refractory partial seizures in a double-blind, randomized, placebo- controlled, parallel-group, multicentre clinical trial. 2011 Co-investigator.
Research Support, Government Entities:
1.
NINDS RO1-NS062092. Neural Basis of Endogenous Potentials in Humans, (P.I.: Sydney Cash, M.D., Ph.D.). 2010 Co- Investigator,
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
My wife or my wife and I own equity in: Merck, 2000 - present Biogen, 2000 - present Regeneron, 2000 - present Medtronics, 2000 - present Medco Health, 2000 - present
Legal Proceedings:
1.
NONE
Mark C. Homonoff, MD
Massachusetts General Hospital (DBH), Boston; Beth Israel Hospital and Mt. Sinai School of Medicine (MCH), New York, NY; Children's Hospital Medical Center of Akron (HM, BHC), Akron, OH; Emory University (GJE), Atlanta, GA; American Academy of Neurology (AB), Minneapolis, MN; and UPMC Shadyside (NAB), Pittsburgh, PA.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Heidi Moawad, MD
Massachusetts General Hospital (DBH), Boston; Beth Israel Hospital and Mt. Sinai School of Medicine (MCH), New York, NY; Children's Hospital Medical Center of Akron (HM, BHC), Akron, OH; Emory University (GJE), Atlanta, GA; American Academy of Neurology (AB), Minneapolis, MN; and UPMC Shadyside (NAB), Pittsburgh, PA.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Bruce H. Cohen, MD, FAAN
Massachusetts General Hospital (DBH), Boston; Beth Israel Hospital and Mt. Sinai School of Medicine (MCH), New York, NY; Children's Hospital Medical Center of Akron (HM, BHC), Akron, OH; Emory University (GJE), Atlanta, GA; American Academy of Neurology (AB), Minneapolis, MN; and UPMC Shadyside (NAB), Pittsburgh, PA.
Disclosure
Scientific Advisory Boards:
1.
DSMB-Stem Cell Transplantation for MNGIE (non-profit) Chairman-External Advisory Board of Clinical Protocols, Neurofibromatosis Consortium, US Army
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Editorial Board for Pediatric Neurology Editorial Board for Mitochondrian
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
New Mentor; content editor
Speakers' Bureaus:
1.
Speakers Bureau: Transgenomic Labs (commercial) through December 31, 2010 Speakers Bureau: United Mitochondrial Disease Foundation (non-profit)
Other Activities:
1.
I am a consultant to Health and Human Services for the Vaccine Compensation Program and review cases and intend to provide testimony in the future.
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Edison Pharmaceuticals. I have received reimbursement for travel expenses related to scientific study management but have not received any financial incentive or money or research support or salary support. My hospital does have a contract with Edison for conducting research but I accept no specific salary support or accept money outside of this contract.
Research Support, Government Entities:
1.
I am a consultant to Health and Human Services for the Vaccine Compensation Program and review cases and intend to provide testimony in the future.
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
I am a consultant to Health and Human Services for the Vaccine Compensation Program and review cases and intend to provide testimony in the future.
Gregory J. Esper, MD, MBA
Massachusetts General Hospital (DBH), Boston; Beth Israel Hospital and Mt. Sinai School of Medicine (MCH), New York, NY; Children's Hospital Medical Center of Akron (HM, BHC), Akron, OH; Emory University (GJE), Atlanta, GA; American Academy of Neurology (AB), Minneapolis, MN; and UPMC Shadyside (NAB), Pittsburgh, PA.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
Maglio, Christopher and Toale Law firm, expert witness, vaccine induced neurological diseases, 2010-2012
Amanda Becker
Massachusetts General Hospital (DBH), Boston; Beth Israel Hospital and Mt. Sinai School of Medicine (MCH), New York, NY; Children's Hospital Medical Center of Akron (HM, BHC), Akron, OH; Emory University (GJE), Atlanta, GA; American Academy of Neurology (AB), Minneapolis, MN; and UPMC Shadyside (NAB), Pittsburgh, PA.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
American Academy of Neurology, Senior Director, Medical Economics & Quality
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Neil A. Busis, MD, FAAN
Massachusetts General Hospital (DBH), Boston; Beth Israel Hospital and Mt. Sinai School of Medicine (MCH), New York, NY; Children's Hospital Medical Center of Akron (HM, BHC), Akron, OH; Emory University (GJE), Atlanta, GA; American Academy of Neurology (AB), Minneapolis, MN; and UPMC Shadyside (NAB), Pittsburgh, PA.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Speaker at courses sponsored by the American Academy of Neurology
Editorial Boards:
1.
Practice and Technology Editor of American Academy of Neurology website, AAN.com until April 2012
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE

Notes

Correspondence to: [email protected]

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