Two things "heard on the street" at today's Medical Home Summit:
1) The recent JAMA article on the failure of the medical home to reduce health costs is provoking the same defensiveness as the infamous 2004 CBO report on "disease management." PCMH advocates are using the same arguments that were used by the old DM vendors to defend their business model back in 2004.
Two of the more common ones heard by the Population Health Blog are that 1) today's model is far improved over the Ver. 1.0 reported in the JAMA article and 2) the improved health status of populations is not correlated with reduced insurance claims expense.
2) The bad news is that employers have given up on health insurance and many are prepared to push their workforce into the health insurance exchanges. The good news is that they are continuing to invest in wellness and health promotion programs for their employees - not because they believe it saves money, but because it increases productivity.
In other words, commercial health insurance and wellness are being de-linked.