Patient Centered Medical Homes Slow to Create Improvements

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Patient centered medical homes have a modest, albeit positive impact on the quality of care in practices in which they are fully adopted, according to the Patient-Centered Primary Care Collaborative's new report, "The Patient Centered Medical Home's Impact on Cost and Quality: An Annual Update of the Evidence, 2012-2013."

The report synthesizes findings from studies on patient centered medical homes, 13 academic or peer-reviewed reports and seven industry reports. Improvements in care still appear to be modest, with most measured categories showing improvements less in less than half of reports reviewed. For each category, percentage of reports in which that category improved (academic, followed by industry) is as follows:

  • Cost reductions: 61 percent/ 57 percent
  • Fewer emergency department visits: 61 percent/ 57 percent
  • Fewer inpatient admissions: 31 percent/ 57 percent
  • Fewer readmissions: 13 percent/ 29 percent
  • Improvement in population health: 31 percent/ 29 percent
  • Improved access: 31 percent/ 14 percent
  • Increase in preventative services: 31 percent/ 29 percent
  • Improvement in satisfaction: 23 percent/ 14 percent

While cost reduction, fewer ED visits and fewer inpatient admissions appear to be areas of comparable success for patient centered medical home goals, readmissions, population health, preventive services, access and satisfaction appear to have benefitted somewhat less from patient centered medical home models as they are currently implemented.

Peer-reviewed and industry reports show differences in improvements inpatient admissions, readmissions and improved access to care, possibly indicating differences in peer-reviewed versus industry metrics for measuring care.

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