Patient-Centered Medical Homes Save Money

A new review of the evidence suggests that patient-centered medical homes can reduce unnecessary use of health-care services and thus health-care costs.

Conducted by the Patient-Centered Primary Care Collaborative, a nonprofit membership group, the review summarizes cost and utilization data from peer-reviewed research, state government evaluations, the health-care industry and evaluations of federal programs related to patient-centered medical homes. Patient-centered medical homes offer enhanced primary care services, with coordinated, team-based care that emphasizes treating the whole person.

Published in February, the report found that this evolving model of health-care delivery is helping control costs by "right-sizing" health-care use. Twenty-three of the 25 studies looking at utilization measures found reductions in emergency room visits, inpatient hospitalizations, hospital re-admissions or other signs of unnecessary health-care utilization. Twenty-one of the 23 studies that included cost measures found cost savings.

"Once again, the data show that by coordinating care through well-established primary-care teams, there is overall improvement in health as evidenced by improvements in measures such as long-term diabetes control," says psychologist W. Douglas Tynan, PhD, director of integrated health care at APA's Center for Psychology and Health. "And with improvements in health, there are reductions in health-care costs."

The evidence also suggests that payment reform is needed as payment systems shift from rewarding the number of health-care services provided to rewarding the outcomes those services achieve.

Primary-care teams should be explicitly rewarded for achieving performance targets, the report's authors write, and incentives should be shared with providers and practices, not just organizations or health systems. In addition, public and private payers should use the same performance measures as a way of preventing what the authors term "measurement fatigue" and building support for value-based payment models among primary-care practices.

To read the report, go to https://www.pcpcc.org/resource/patient-centered-medical-homes-impact-cost-and-quality-2014-2015.