Pennsylvania Medical Home Model Links Data, Quality, Savings

Performance improvements are attributed in part to tying physicians' performance bonuses to actionable patient data. But "not all medical home interventions are alike," one researcher notes.

A medical home model in Pennsylvania that provided timely and pertinent patient data to physicians and paid bonuses for the resulting improved care showed significant improvements over comparison practices, a RAND study shows.

The study analyzed data from 17,363 patients from 27 pilot and 29 comparison practices in the northeast region of the Pennsylvania Chronic Care Initiative from 2009–2012. The pilot practices were recognized by the National Committee for Quality Assurance as medical homes, but did not receive payment for the designation.

By year three, the pilot practices had achieved statistically significantly better changes in performance on four measures of diabetes care and breast cancer screening. In addition, as measured per 1,000 patients per month, the pilot practices saw:

• 1.7 fewer hospitalizations
• 4.7 fewer emergency department visits
• A 3.2% lower rate of ambulatory care-sensitive emergency department visits
• Specialty care visits declined by 17.3 visits per month