The Medical Home's Impact on Cost & Quality

Executive Summary

This annual report highlights recently published clinical, quality, and financial outcomes of patient-centered medical home (PCMH) initiatives from across the United States. Profiling a showcase of PCMH initiatives, this report focuses on studies released between August 2012 and December 2013 and identifies where they are happening, who is leading them, and highlights the outcomes they are achieving. In addition to the results from these 21 most recent studies, the report includes a summary of PCMH initiatives taking place throughout the US since 2009, which can be found in Appendix A, reflecting 54 different studies organized by state and location. Although the evidence is early from an academic perspective, and this report does not represent a formal peer-reviewed meta-analysis of the literature, the expanding body of research provided here suggests that when fully transformed primary care practices have embraced the PCMH model of care, we find a number of consistent, positive outcomes.

A summary of key points from this year’s report include:

1. PCMH studies continue to demonstrate impressive improvements across a broad range of categories including: cost, utilization, population health, prevention, access to care, and patient satisfaction, while a gap still exists in reporting impact on clinician satisfaction.
2. The PCMH continues to play a role in strengthening the larger health care system, specifically Accountable Care Organizations and the emerging medical neighborhood model.
3. Significant payment reforms are incorporating the PCMH and its key attributes.

The findings are indeed encouraging and the evidence base for the model continues to build at a rapid pace. While we need to be cautious about over-promising what the PCMH alone can deliver, our review of the recent literature affirmatively shows improvements across a number of categories. Our review also suggests some gaps in the evidence and ways to improve future PCMH studies. More robust analyses regarding how PCMH’s function, transform and improve outcomes for all patients and their families are critical to the long-term success of primary care, as well as helping the US to achieve much needed, broad-based delivery reform.