A patient-centered medical home (PCMH) model resulted in reduced costs of care, unnecessary emergency room (ER) and hospital visits, and improved population health, according to a research report by the Patient-Centered Primary Care Collaborative.
The Collaborative partnered with Milbank Memorial Fund to produce the report, "The Patient-Centered Medical Home's Impact on Cost & Quality: An Annual Update of the Evidence, 2012-2013," to examine cost and utilization, population health and prevention, access to care, and patient or clinician satisfaction under PCMH.
The report focused on studies released between August 2012 and December 2013 and revealed common metrics, including:
Decreases in the cost of care: 61 percent of peer-reviewed studies and 57 percent of industry reports noted drops in per member, per month costs, return on investment and total cost of care.
Reductions in the use of unnecessary or avoidable services: 61 percent of peer-reviewed studies and 57 percent of industry-generated reports showed drops in ER or urgent care visits, while 31 percent of peer-reviewed studies and 57 percent of industry-generated reports saw declines in inpatient admissions, with hospital readmissions falling in 13 percent of peer-reviewed studies and 29 percent of industry-generated ones.
Improvements in population-health indicators and preventive services: 31 percent of peer-reviewed studies and 29 percent of industry-generated studies saw better controlled HbA1c, blood pressure and LDL levels, as well as an increase in screening and immunization rates.
Improvements in access to care: 31 percent of peer-reviewed studies and 29 percent of industry-generated studies noted better overall access to primary care doctors, as well as non-face-to-face visits.Improvements in patient satisfaction: 23 percent of peer-reviewed and 14 percent of industry-generated studies saw a rise in overall satisfaction, the number of patients who recommended the practice to family and friends, and increased satisfaction with provider communications.
The report also found PCMHs play a role in strengthening the larger healthcare systems, especially accountable care organizations. "Many of the nation's highest-performing ACOs embrace their strong PCMH component, and for this reason, PCMHs are well-positioned to lead and drive change across ACOs," the report states.
The PCMH model is also being incorporated into significant payment reforms, including Congressional reforms to the Medicare sustainable growth rate, which would aid in moving the U.S. healthcare system away from fee-for-service toward alternative payment methods, including ones build around the PCMH model, according to the report.
A study from the University of California Los Angeles and the University of Southern California in 2013 showed success of PCMHs even in an urban, safety-net setting, FierceHealthcare previously reported. The Galaxy Health program, which debuted at Los Angeles County+USC Medical Center (LAC+USC) in 2012, proved that intuitive and inexpensive interventions improve patient care and physician and staff morale.
To learn more:
- here's the report (.pdf)