Latest Published Evidence Demonstrates Improved Outcomes Associated with Patient-Center Medical Homes and Advanced Primary Care

Researchers find improved outcomes in terms of cost, quality and utilization, but not uniformly

July 10, 2017 (WASHINGTON, DC) — Today at a briefing on Capitol Hill hosted by the Congressional Primary Care Caucus, the Patient-Centered Primary Care Collaborative (PCPCC) unveiled its latest report highlighting new evidence that links the patient-centered medical home (PCMH) and other forms of advanced primary care with improved outcomes, but not in every study examined. The Impact of Primary Care Practice Transformation on Cost, Quality, and Utilization reviews PCMH results from 45 peer-reviewed reports and additional government and state evaluations. Implementation of the PCMH and high performing primary care differs depending upon the needs and preferences of those delivering, receiving, and paying for related care. 

“This year’s report uses a more rigorous research design and resulted in positive results overall with respect to the PCMH and other advanced primary care models, particularly those that have been in place for four or more years,” said Ann Greiner, President & CEO, Patient-Centered Primary Care Collaborative. “Evolving models make assessment challenging, and I applaud the Robert Graham Center for their disciplined approach to this report, which can help policymakers discern how to best support the continued positive evolution of primary care.”

The sixth annual PCPCC report, authored by the Robert Graham Center of the American Academy of Family Physicians and published with support from the Milbank Memorial Fund, employed broader search terms and more rigorous search criteria that evaluated studies, reports, and evaluations published between November 1, 2015 to February 28, 2017. It also features examples and data from PCMH programs, such as Blue Cross Blue Shield of Michigan, which leads one of the oldest PCMH programs, now in its eighth year with seven years of data; the Comprehensive Primary Care Initiative launched by the Center for Medicare and Medicaid Innovation; and state primary care initiatives including Colorado, Minnesota, and Oregon.

“It is vital to continue studying and evaluating what is and is not working with primary care transformation, given the impact it has to improve patient outcomes and the investment on the part of the federal government, states, and commercial payers in PCMH and other strategies to advance primary care,” said Christopher F. Koller, President, Milbank Memorial Fund.

The new report highlights that positive outcomes related to the PCMH and high performing primary care continue to mount, while acknowledging that the PCMH model has evolved since the Joint Principles for PCMH were first defined in 2007. Due to this evolution and the emergence of new models of high performing primary care, assessment of the evidence has been challenging. In addition, the researchers found that:

  • Overall, analysis of the studies revealed that the longer a practice had been transformed, and the higher the risk of the patient pool in terms of comorbid conditions, the more significant the positive effect of practice transformation, especially in terms of cost savings
  • Peer-reviewed, CMS-initiative and state-specific data showed either a trend towards a positive effect on quality, or no impact on quality, though few results were statistically significant
  • All studies that reported on patient satisfaction showed positive results
  • Team-based interventions, including case management, and having a usual source of care have positively impacted the patient experience
  • Utilization outcomes were mixed. While most studies and state reports did show an increase in outpatient visits, this didn’t uniformly result in a concomitant decrease in ER visits or inpatient stays

"BCBS companies are driving patient-centered, value-based innovations across the nation to improve care and outcomes and help make coverage more affordable. As evidenced in this year’s report, Blue Cross and Blue Shield (BCBS) companies are working alongside health care professionals to deliver patient-focused approaches that help patients get healthy faster and stay healthy longer,” said Justine Handelman, senior vice president of the Office of Policy and Representation at the Blue Cross Blue Shield Association. “By investing in primary care and putting the patient at the center of their care, these innovative programs - in the private sector as well as through collaboration with the public sector - are improving health, decreasing hospital admissions and emergency room visits and reducing avoidable health care costs.”

Speakers at the briefing include: Ann Greiner, Patient-Centered Primary Care Collaborative; Justine Handelman, Blue Cross Blue Shield Association; Dr. Yalda Jabbarpour, Robert Graham Center/Georgetown University Department of Family Medicine; Christopher F. Koller, Milbank Memorial Fund; Dr. Jean Malouin, Blue Cross Blue Shield of Michigan Value Partnerships; and Dr. Gregg Stefanek, Covenant Healthcare. The report was funded by the Milbank Memorial Fund, and the event was sponsored by the Blue Cross Blue Shield Association.


About the Patient-Centered Primary Care Collaborative:

Founded in 2006, the Patient-Centered Primary Care Collaborative (PCPCC) is a not-for-profit multi-stakeholder membership organization dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home. Representing a broad group of public and private organizations, the PCPCC’s mission is to unify and engage diverse stakeholders in promoting policies and sharing best practices that support growth of high-performing primary care and achieve the “Quadruple Aim”: better care, better health, lower costs, and greater joy for clinicians and staff in delivery of care.

About the Robert Graham Center of the American Academy of Family Physicians:

The Robert Graham Center staff is made up of a group of clinician researchers, as well as a variety of social scientists from sociologists to geographers to economists. Our aim is to improve individual and population healthcare delivery through the generation or synthesis of evidence that brings a family medicine and primary care perspective to health policy deliberations from the local to international levels.

About the Millbank Memorial Fund:

The Milbank Memorial Fund is an endowed operating foundation that works to improve the health of populations by connecting leaders and decision makers with the best available evidence and experience. Founded in 1905, the Fund engages in nonpartisan analysis, collaboration, and communication on significant issues in health policy. It does this work by publishing high-quality, evidence-based reports, books, and The Milbank Quarterly, a peer-reviewed journal of population health and health policy; convening state health policy decision makers on issues they identify as important to population health; and building communities of health policymakers to enhance their effectiveness.


Media Contact:

Sarah Wood
Patient-Centered Primary Care Collaborative

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