[Federal Register Volume 74, Number 238 (Monday, December 14, 2009)]
[Presidential Documents]
[Pages 66207-66208]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-29783]


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  Federal Register / Vol. 74, No. 238 / Monday, December 14, 2009 / 
Presidential Documents  

[[Page 66207]]


                Memorandum of December 9, 2009

                
Medicare Demonstration to Test Medical Homes in 
                Federally Qualified Health Centers

                Memorandum for the Secretary of Health And Human 
                Services

                My Administration is committed to building a high-
                quality, efficient health care system and improving 
                access to health care for all Americans. Health centers 
                are a vital part of the health care delivery system. 
                For more than 40 years, health centers have served 
                populations with limited access to health care, 
                treating all patients regardless of ability to pay. 
                These include low-income populations, the uninsured, 
                individuals with limited English proficiency, migrant 
                and seasonal farm workers, individuals and families 
                experiencing homelessness, and individuals living in 
                public housing. There are over 1,100 health centers 
                across the country, delivering care at over 7,500 
                sites. These centers served more than 17 million 
                patients in 2008 and are estimated to serve more than 
                20 million patients in 2010.

                The American Recovery and Reinvestment Act of 2009 
                (Recovery Act) provided $2 billion for health centers, 
                including $500 million to expand health centers' 
                services to over 2 million new patients by opening new 
                health center sites, adding new providers, and 
                improving hours of operations. An additional $1.5 
                billion is supporting much-needed capital improvements, 
                including funding to buy equipment, modernize clinic 
                facilities, expand into new facilities, and adopt or 
                expand the use of health information technology and 
                electronic health records.

                One of the key benefits health centers provide to the 
                communities they serve is quality primary health care 
                services. Health centers use interdisciplinary teams to 
                treat the ``whole patient'' and focus on chronic 
                disease management to reduce the use of costlier 
                providers of care, such as emergency rooms and 
                hospitals.

                Federally qualified health centers provide an excellent 
                environment to demonstrate the further improvements to 
                health care that may be offered by the medical homes 
                approach. In general, this approach emphasizes the 
                patient's relationship with a primary care provider who 
                coordinates the patient's care and serves as the 
                patient's principal point of contact for care. The 
                medical homes approach also emphasizes activities 
                related to quality improvement, access to care, 
                communication with patients, and care management and 
                coordination. These activities are expected to improve 
                the quality and efficiency of care and to help avoid 
                preventable emergency and inpatient hospital care. 
                Demonstration programs establishing the medical homes 
                approach have been recommended by the Medicare Payment 
                Advisory Commission, an independent advisory body to 
                the Congress.

                Therefore, I direct you to implement a Medicare 
                Federally Qualified Health Center Advanced Primary Care 
                Practice demonstration, pursuant to your statutory 
                authority to conduct experiments and demonstrations on 
                changes in payments and services that may improve the 
                quality and efficiency of services to beneficiaries. 
                Health centers participating in this demonstration must 
                have shown their ability to provide comprehensive, 
                coordinated, integrated, and accessible health care.

                This memorandum is not intended to, and does not, 
                create any right or benefit, substantive or procedural, 
                enforceable at law or in equity by any

[[Page 66208]]

                party against the United States, its departments, 
                agencies, or entities, its officers, employees, or 
                agents, or any other person.

                You are authorized and directed to publish this 
                memorandum in the Federal Register.
                
                
                    (Presidential Sig.)

                THE WHITE HOUSE,

                    Washington, December 9, 2009.

[FR Doc. E9-29783
Filed 12-11-09; 8:45 am]
Billing code 4110-60-P