Patient-Centered Medical Homes

An enhanced way to deliver primary care that provides ongoing, team-based, and coordinated care.  PCMHs are now being tested for their ability to improve outcomes and limit costs growth. 

Effects of the ACA on Health Care Cost Containment

Issue Brief
Mar. 2, 2017

This brief reviews the evidence on how key ACA provisions have affected the growth of health care costs. Coverage expansions produced a predictable jump in health care spending, amidst a slowdown that began a decade ago. Although we have not returned to the double-digit increases of the past, the authors find little evidence that ACA cost containment provisions produced changes necessary to “bend the cost curve.” Cost control will likely play a prominent role in the next round of health reform and will be critical to sustaining coverage gains in the long term.

Pennsylvania’s Medical Home Initiative: Reductions in Healthcare Utilization and Cost Among Medicaid Patients with Medical and Psychiatric Comorbidities

Jun. 27, 2016

Karin V. Rhodes, Simon Basseyn, Robert Gallop, Elizabeth Noll, Aileen Rothbard, and Paul Crits-Christoph

The Chronic Care Initiative (CCI) was a large state-wide patient-centered medical home (PCMH) initiative in Pennsylvania in place from 2008–2011. At its height, it included 783 providers and served more than 1.18 million patients. Evaluation of the program, in terms of quality, utilization, and cost outcomes has been mixed. This study assessed whether the CCI had an impact on the utilization and costs for Medicaid patients with chronic medical conditions and comorbid psychiatric or substance use disorders. The investigators analyzed Medicaid claims to compare changes in utilization and...

Asking the Patient About Patient-Centered Medical Homes: A Qualitative Analysis

Sep. 21, 2015

Jaya Aysola, Rachel M. Werner, Shimrit Keddem, Richard SoRelle, and Judy A. Shea

In the Journal of General Internal Medicine, Jaya Aysola and colleagues, including Rachel Werner and Judy Shea, assess patients’ perspectives of the patient-centered medical home (PCMH) model and compare responses by degree of practice-level PCMH adoption and patient race/ethnicity. The authors interviewed 48 patients with diabetes and/or hypertension enrolled in PCMHs within the University of Pennsylvania Health System. They purposively sampled minority and non-minority patients from the four highest-ranked and four lowest-ranked PCMH-adopting practices to determine whether...

Impact of the Patient-Centered Medical Home on Veterans’ Experience of Care

Sep. 14, 2015

Ashok Reddy, Anne Canamucio, Rachel Werner

In the American Journal of Managed Care, Ashok Reddy and colleagues, including Rachel Werner, assess whether the adoption of patient-centered medical homes improves patient experiences of care. Using a linear probability model they tested whether the adoption of the medical home model is associated with changes in patient experiences of care, looking at primary care sites in one region of the Veterans Health Administration. Despite a significant increase in medical home implementation, the authors find no association between medical home adoption and five domains of patient...

Perceptions of High-Risk Patients and Their Providers on the Patient-Centered Medical Home

Apr. 1, 2015

Shreya Kangovi, Katherine Kellom, Christopher Sha, Sarah Johnson, Casey Chanton, Tamala Carter, Judith A. Long, David Grande

In the Journal of Ambulatory Care Management, Shreya Kangovi and colleagues, including Judith Long and David Grande, analyze patient and primary care practice staff perceptions of patient-centered medical homes (PCMH). Through a multi-state qualitative survey, the authors explore areas of agreement and tension between the perceptions of chronically ill, low-income patients and their primary care practice staff on PCMH principles and implementation strategies. PCMH are a team-based delivery model that emphasize continuity of care and health outcomes. Kangovi and colleagues’ conclude some...

Physician Referrals, Delivery System Reform, and The Diffusion of Information

Jan, 2015
Principal Investigator:
Lawton R. Burns, PhD, MBA

Abstract: Physician-to-physician referrals play a central role in the health care systems and are drives of costs and quality. There is evidence that referrals are currently misused and overused and recognition that they will have to change if health reform objectives such as care coordination and cost reduction are to be achieved (Son et al., 2014). Indeed, many of the models of care supported by the Affordable Care Act (e.g., accountable care organizations (ACOs), patient-centered medical homes, bundled payments) depend on physicians making high-value referrals.

Do Patient-Centered Medical Homes Reduce Emergency Department Visits?

Aug. 12, 2014

Guy David, Candace Gunnarsson, Philip A. Saynisch, Ravi Chawla, Somesh Nigam

In Health Services Research, Guy David and colleagues evaluate whether patient-centered medical homes (PCMHs) reduce emergency department (ED) visits among patients  with and without chronic conditions. The authors use data from approximately 460,000 Independence Blue Cross patients enrolled in 280 primary care practices, all of which converted to PCMH status between 2008 and 2012. PCMH certification was associated with a 5-8% reduction in ED visits among a practice's chronically ill patients, but had no effect on patients without chronic medical conditions. These findings were...