PCMH Data Certifies Proof of Concept

Data collected from 11 states strongly suggests that the question to ask about the patient-centered medical home model is not whether it reduces healthcare costs and improves outcomes, but how well.

Forgive me for preaching to the choir, but another round-up of studies released this week re-confirms what we already know: Patient-centered medical homes improve health outcomes and reduce costs.

In fact, the question is no longer "will they work?" Evidence increasingly settles that question. Now the questions center around just how effective PCMHs can be in reducing costs and improving outcomes.

Consider the findings in an analysis released this week from the Patient-Centered Primary Care Collaborative. It's a composite of peer-review and industry-generated studies, showing that the PCMH model is reducing costs of care, unnecessary emergency department and hospital visits, and increasing the use of preventive services and improving population health.

These findings are more than regional success stories. The study includes data from 20 PCMH projects in 11 states from New Hampshire to Alaska, and national data from PCMHs serving active-military and veterans, which show that 60% of the PCMH evaluations reported decreases in cost of care or use of unnecessary services, while 30% saw improved population health.

Diabetes Care Results
The Colorado Multi-Payer PCMH Pilot Model that focused on diabetic care posted particularly impressive result over three years, which included:

A 15% reduction in ED visits, compared with 4% for a control group;
18% fewer inpatient admissions compared to an 18% increase for the control group;
No increase in specialty referrals compared with 10% increase for the control group; and
A return on investment ranging from 2.5:1 to 4.5:1 for every dollar spent by WellPoint on the pilot.

In addition, 95% of the patients said the care was efficient and well organized and 97% said they would recommend the program to family and friends.

The Blue Cross Blue Shield of Michigan Physician Group Incentive Program reported that practices with full PCMH implementation had savings of $26.37 per patient per month and a 5.1% higher "prevention composite score" than colleagues in traditional practice settings. 

While not every PCMH pilot can claim these levels of success, virtually every pilot examined by the Collaborative demonstrated improvements over the traditional fee-for-service practice model that provides incremental, episodic care and incentivizes volume.

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