Executive Update: CMS Health Demonstration Projects and Policies

This executive update provides an update on the reimbursement policy trends from the Center for Medicare and Medicaid (CMS) regarding digital health applications and services. It analyzes the status of key Medicare demonstration projects and their impact. The report also examines state-run Medicaid program’s stance on emerging digital health technologies.

“The government reimbursement policy remains a sore spot for the growth of the digital health industry,” said Harry Wang, Senior Analyst with Parks Associates. “Technology vendors should learn from the experience of the disease management industry with the Medicare Health Support Pilot program and find a better way to engage government at both the federal and state levels and eventually convince them of the value of technology to the U.S. healthcare industry.”

The Executive Update is a concise, executive-level summary of the current state of the market, evolutionary path, and the implications for companies doing business in this space.

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Download Table of Contents (PDF)

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

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

Publish Date: 3Q 2008

Pages: 31

Authored By:
Harry Wang - Senior Director of Research

Authored by Harry Wang
Executive Editor: Tricia Parks
Published by Parks Associates

© July 2008 Parks Associates
Dallas, Texas 75230

All rights reserved.  No part of this book may be reproduced, in any form or by any means, without permission in writing from the publisher.

Printed in the United States of America. 

Parks Associates has made every reasonable effort to ensure that all information in this report is correct.  We assume no responsibility for any inadvertent errors.

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