New Report Finds Medical Homes Improve Health Care Quality, Costs & Utilization
FOR IMMEDIATE RELEASE
Latest Published Evidence Finds Positive Outcomes Associated with Comprehensive Primary Care
As federal government redefines Medicare payments, health care experts discuss findings from new report on patient-centered medical home initiatives that control costs and improve quality
February 2, 2016 (WASHINGTON, DC) — Today at a briefing on Capitol Hill hosted by the bipartisan 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) with lower costs and improved health care quality. "The Patient-Centered Medical Home's Impact on Cost and Quality: Annual Review of Evidence 2014-2015” highlights 30 primary care PCMH initiatives from around the country that measured cost and utilization of services, and includes an analysis of the findings. The report also describes the payment model for each initiative and the implications of Medicare payment reform.
Does the patient-centered medical home work? The latest research demonstrates that the PCMH – or comprehensive primary care – can control costs and promote the right care,” said Marci Nielsen, PhD, MPH, CEO of the PCPCC and lead author of the report. “The medical homes that have been around the longest showed the most improvement. And those that participated in multi-payer collaboratives – where payers and providers align payment models and performance measures – showed the most impressive costs and utilization outcomes. These are important lessons as we implement federal payment reform: investments take time, sufficient resources, and collaboration to pay off.”
The fifth annual PCPCC report, published with support from the Milbank Memorial Fund, reviewed 17 peer-reviewed studies, 4 state government evaluations, 7 industry reports, and 3 independent evaluations of large federal PCMH initiatives, all published between October 2014 and November 2015. Panelists at the Capitol Hill briefing discussed the findings in light of the federal government’s forthcoming definition and requirements for status as a PCMH, which is in progress right now and will influence future enhanced Medicare payments.
The question is not whether we have to transform primary care, but how,” said Christopher F. Koller, president of the Milbank Memorial Fund. “The evidence continues to build that a high performing, patient-centered medical home – especially when supported by multiple, committed and aligned payers – is the foundation for a better performing health care system. The findings in this year’s evidence report are particularly timely as Medicare’s participation in the multi-payer projects is scheduled to conclude at the end of 2016.”
“This year’s PCPCC annual evidence report highlights several Blue Cross and Blue Shield (BCBS) companies that are working alongside health care providers to help patients get healthy faster and stay healthy longer,” said Alissa Fox, 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 are improving health, decreasing hospital admissions and emergency room visits and reducing avoidable health care costs.”
The new report also highlights the critical need to assess the value of the PCMH from the perspective of patients, providers, and payers. While the goals or attributes for PCMH practices are often similar, the PCMH model is not “one size fits all.” PCMH practices differ in terms of their implementation, measurement, and performance, and the terms “medical home” and “PCMH” are not well understood by the public.
“Our findings should help solidify support for investing in primary care. It’s the smart thing to do, but it isn’t simple,” said co-author Len Nichols, PhD, an economist and director of the Center for Health Policy and Research at George Mason University. “The push for value-based purchasing by the Centers for Medicare and Medicaid Services and Congressional passage of the Medicare Access and CHIP Reauthorization Act (MACRA) are immensely important steps in the right direction to scale and spread the PCMH. But we also need to know which components of the PCMH matter most. Better defining the medical home – with clear measures to implement, recognize, and evaluate it – will help explain the value to patients, providers, and payers.”
The report concludes with a call for comprehensive payment reform, alignment of payment and performance measurement, and a unified multi-stakeholder voice that speaks to the importance of alternative payment reforms to support the PCMH model.
“For most Americans, primary care serves as the entry point and touchstone of the health care system, delivering and coordinating care for patients and families, with an emphasis on promoting population health and managing chronic illness,” said PCPCC Board Chair Douglas Henley, MD, CEO of the Academy of Family Physicians (AAFP). “As such, primary care is well positioned to help repair and optimize our broken care delivery system. With greater investment in and support for comprehensive patient-centered primary care through the PCMH, we can more systematically promote Triple Aim outcomes of better care, smarter spending, and healthier people. We can also make a much needed positive impact on improving the satisfaction and ‘joy of practice’ of primary care teams.”
All of the studies, programs, and reports included in this publication can be found online on the PCPCC’s Primary Care Innovations and PCMH Map. 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: Rep. Joe Courtney (D-CT), co-chair of the Congressional Primary Care Caucus; Rep. David Rouzer (R-NC), co-chair of the Congressional Primary Care Caucus; Douglas Henley, MD, FAAFP, executive vice president and CEO, American Academy of Family Physicians; Marci Nielsen, PhD, MPH, chief executive officer, PCPCC; Alissa Fox, senior vice president, Office of Policy and Representation, the Blue Cross Blue Shield Association; Christopher F. Koller, president, Milbank Memorial Fund; and Len Nichols, PhD, director of the Center for Health Policy Research and Ethics at George Mason University. 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 PCPCC
Founded in 2006, the PCPCC is a not-for-profit membership organization 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 volunteer members, Stakeholder Centers, experts, and thought leaders focused on key issues of delivery reform, payment reform, patient engagement, and benefit design to drive health system transformation. For more information, or to become an executive member, visit www.pcpcc.org.
Editor’s note: Supplemental infographics available upon request.
