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CONTACT: Caroline DeLaney

Jan. 30, 2015 EST
caroline@pcpcc.org | (352) 258-0090

New Report Finds Patient-Centered Medical Homes Improve Care, Reduce Costs

Industry experts discuss findings from a new PCPCC analysis of 28 academic studies, industry reports, and state government evaluations

WASHINGTON - Today at a briefing on Capitol Hill, the Patient-Centered Primary Care Collaborative (PCPCC) released a new publication highlighting the significant impact the patient-centered medical home (PCMH) has on improving quality and reducing costs of primary care delivery. The PCPCC convened health policy and industry experts from Blue Cross Blue Shield Association, Milbank Memorial Fund, Anthem, The Center for Medicare & Medicaid Innovation, and others to discuss the latest PCMH evidence highlighted in The Patient-Centered Medical Home’s Impact on Cost and Quality, Annual Review of Evidence, 2013-2014.

“Enhanced primary care in the form of the PCMH has the potential to change the quality and cost of health care in America,” said PCPCC CEO Marci Nielsen. “This report serves as a go-to resource to inform policymakers, providers, payers, and patients on the most recent evidence regarding the PCMH and its impact on the health care marketplace.”

The third annual Milbank-funded report analyzes new evidence from primary care PCMH initiatives taking place in both public and private markets throughout the United States. The publication includes an aggregation of PCMH outcomes from a combination of 28 peer-reviewed studies, state government program evaluations, and industry reports.

14 Peer-reviewed scholarly publications

• Six of the 10 studies reported reductions in cost (60 percent)*
• 12 of the 13 studies reported improvements in utilization (92 percent)*

*Not all 14 studies measured both cost and utilization.

7 State government reports

• All seven reported reductions in cost (100 percent)
• Six reported improvements in utilization (86 percent)

7 Industry reports

• Four reported reductions in cost (57 percent)
• Six reported improvements in utilization (86 percent)

“The evaluations of the PCMH described in the report underscore the growing evidence base that ties the medical home model of care to reductions in health care costs and improvements in quality,” said Christopher Koller, president of the Milbank Memorial Fund. “However, in order for the PCMH to be sustainable, we need greater investment in primary care and less reliance on the fee-for-service payment system.”

Across the country, public programs as well as private health plans are leading efforts to improve patient engagement and health outcomes through enhanced payments for chronic condition management and care coordination.

“Blue Cross and Blue Shield companies are leading the transformation of the healthcare system to reward quality care and better outcomes for all individuals,” said Justine Handelman, vice president, legislative and regulatory policy at Blue Cross Blue Shield Association. “Spending more than one in five medical claims dollars in value-based care programs located in virtually every state, the Blues are creating innovative models that align incentives, support care coordination, and put patients first.”

The report concludes with perspectives from several guest experts on key areas integral to the future development of enhanced primary care and the PCMH. These areas include: integration into medical neighborhoods and accountable care organizations; financial support for primary care; consumer and public engagement; development of team-based health professions; and the role of technology in the PCMH and primary care.

All of the studies, programs, and reports included in this publication can be found online on the Primary Care Innovations and PCMH Map, www.pcpcc.org/initiatives. The Map captures the extensive work and commitment of nearly 500 public and private initiatives nationwide that are working to improve the U.S. health care system through enhanced primary care and the PCMH.

Speakers at the briefing include: Doug Henley, MD, FAAFP, executive vice president and chief executive officer, American Academy of Family Physicians; Marci Nielsen, PhD, MPH, chief executive officer, PCPCC; Katherine Clark, DO, practicing physician, Ohio Comprehensive Primary Care Initiative; Justine Handelman, vice president, legislative and regulatory policy at Blue Cross Blue Shield Association; Chris Koller, president, Milbank Memorial Fund; Rahul Rajkumar, MD, JD, acting deputy director at the Center for Medicare & Medicaid Innovation; and Julie Schilz, BSN, MBA, director, Care Delivery Transformation, Anthem. The report was funded by the Milbank Memorial Fund and the event was sponsored by the Blue Cross Blue Shield Association.

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About the Patient-Centered Primary Care Collaborative (PCPCC): Founded in 2006, the PCPCC is dedicated to advancing an effective and efficient health care system built on a strong foundation of primary care and the patient-centered medical home (PCMH). The PCPCC achieves its mission through the work of its five Stakeholder Centers, experts and thought leaders focused on key issues of delivery reform, payment reform, patient engagement, and employer benefit redesign to drive health system transformation. For more information, visit www.pcpcc.org.