Patient-Centered Medical Homes- the latest research findings

Recently, a three year evaluation of a medical home pilot was published in JAMA that found limited effects of the medical home. On the surface, these findings run counter to the Health Services Research Journal study first published in July 2013 showing positive impacts on cost and quality of the Blue Cross Blue Shield of Michigan PCMH program – which translated into roughly $155M in savings over the program’s first three years. 
 
However, there are potentially key reasons why these studies yielded different results: 1) The PCMH programs are designed and administered differently; 2) The programs were implemented in different settings. 
 
Not all PCMH programs are the same 
 
Translating theory into practice is always a challenge, and such is the case with the Patient-Centered Medical Home (PCMH). Because this translation is still in its infancy, there is neither a standard set of criteria nor a “gold standard” that defines what constitutes a “Patient Centered Medical Home”. As a result, studies of the impacts of “PCMH” are not always directly comparable to one another, either due to differences in how medical homes are defined or due to the contexts in which they are implemented. 
 
In the past few years, several definitions of PCMH have arisen – two of which are the NCQA PCMH and the BCBSM PCMH. An Urban Institute study in 2012 compared several PCMH recognition programs. The two excerpts below shows the findings from that study, and demonstrate some of the similarities and differences between the BCBSM and 2008 NCQA program implemented in Southeast Pennsylvania.