In a study of medical home implementation at federally qualified health centers, researchers found that costs increased.
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According to CareFirst, members in its medical home arrangements had significantly lower utilization of hospital and saved $130 million over expected costs.
http://www.prnewswire.com/news-releases/patient-centered-medical-home-program-shows-promising-quality-trends-and-continued-savings-on-expected-costs-266580761.htmlA study published in the Annals of Internal Medicine finds that medical home-qualified physician groups produced improvement on only four of ten quality improvement measures, compared to non-medical home practices using EHRs or practices using paper records, and the improvements were quite modest.
http://annals.org/article.aspx?articleid=1877017An analysis reported in the American Journal of Managed Care suggests that a patient-centered medical home can reduce reduce utilization and spending for the highest-risk, and therefore highest-cost, patients. Almost all the reductions occurred through fewer inpatient hospital admissions.
http://www.ajmc.com/publications/issue/2014/2014-vol20-n3/medical-homes-and-cost-and-utilization-among-high-risk-patients/1It is cooling down across most of the country, but our Potpourri remains red-hot, with nuggets on the moderation in health spending over the last few years, how to change automatic health behaviors, EHRs and diabetes care, a medical home pilot in Colorado and an ACO demonstration in Maine.
One of the hot new concepts is use of “medical home” physician practices to improve quality and lower costs. A study from Health Affairs suggests that practices having medical home characteristics don’t necessarily do better in producing good outcomes for outpatients.
Welcome to 2012, when you can once again expect a series of high-quality Potpourris from our immense data bank! Our initial foray includes the Independence at Home CMS demo, discharge summaries and hospital readmissions, CMS’ quality measures for Medicaid patients, private equity fundraising, medical homes and cost savings for Medicaid patients and the effect of poor discharge summaries on nursing home patients.
Another one of the concepts being counted on to help improve health care quality and lower costs in the wake of reform is the “medical home.” An AHRQ draft review finds little evidence on quality effects or cost savings, but also suggests there is promise in the approach.
No Potpourri next week due to the holiday, so enjoy this festive collection of health care nuggets, including pay-for-performance in large physician groups, employer views on the effect of the reform law, the effect of physician financial interest in cardiac testing, experience with high deductible plans, medical homes and quality improvement and for-profit and non-for-profit hospital treatment of the uninsured.
October already!! Our 39th Potpourri of the year has many autumnal pleasures including selections on CMS’ Comprehensive Primary Care Initiative, a proposed guidance for FDA to use for mHealth regulation, end-of-life care discussions, CMS’ multi-payer database award, expected 2012 medical trend, and delivery of unnecessary care by doctors.
Research continues to accumulate suggesting that the patient-centered medical home can save money while improving care and patient satisfaction. A new report summarizes this evidence, but the applicability of the model across the entire system has yet to be demonstrated.
A study of a medical home model indicates reductions in hospital admissions and readmissions and possibly a reduction in total spending. It is not clear, however, what the full economic impact was nor is it clear that most practices would see the results that this particular provider system did.
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
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