Better patient-centered medical homes cost more

Running a better patient-centered medical home (PCMH) may have higher operating costs, according to a study in the Journal of the American Medical Association. Researchers from the University of Chicago found that having an overall score that was 10 points higher than the average performance score was associated with a $2.26 higher operating cost per patient per month, which translates to an annual cost of $508,207.

PCMHs scoring 10 points above the mean for patient tracking and for quality improvement both were associated with higher operating cost per physician full-time equivalent (FTE) and per patient per month.

However, better access/communication was associated with a lower operating cost per physician FTE. For instance, the cost of providing telephone-based clinical advice could be offset if it replaces a more costly in-person visit, the researchers wrote.

Researchers said the larger price-tag is fairly small compared with the potential cost savings from avoided hospitalization and emergency department visits, reported MedPage Today. Previous studies have estimated savings of up to $18 per member, per month from patient-centered medical homes, according to the study.

In fact, patient-centered medical homes already are recouping savings and improving care. CareFirst Blue Cross Blue ­Shield PCMH has saved $40 million in the program's first year, while the first-year results for Horizon Blue Cross Blue Shield of New Jersey's PCMH are a 10 percent decline in the cost of care per member, a 26 percent decline in emergency room visits and a 25 percent decrease in hospital readmissions.

With the trend toward patient-centered medical homes, healthcare organizations can heed the lessons learned shared at the American College of Healthcare Executives' annual congress in March. Laura Etchen, partner at healthcare consulting company The Chartis Group in Chicago, recommended considering National Committee for Quality Assurance accreditation to attract physicians, and John Butterly, executive vice president for medical affairs at Dartmouth-Hitchcock in Lebanon, N.H., advised healthcare leaders to engage physicians and nurses by being honest about implementing the new care model, FierceHealthcare previously reported.

To learn more:
- read the study
- here's the MedPage article

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