Patient centered care for an admitted patient entails communication between the hospitalist caring team and the Patient Centered Medical Home. There are several solutions and one such solution per the NEJM paper (Goroll and Hunt) is to ask the PCP to become a consultant to the hospitalist and formalize this communication with a payment. Could we envision other creative ways by which a PCMH team member can provide real time information to the hospitalists using CCDA's, a phone call? Could the communication on phone between the PCMH team and Hospitalist team be reimbursed at a low level ($42) same as the CMS care coordination bill(99490)?
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