Dive Brief:
- A new study by Philadelphia's Independence Blue Cross demonstrated lowered costs and utilization rates for high-risk members through the use of patient-centered medical homes.
- The three-year study, which was published in The American Journal of Managed Care, followed about 700 of the health plans members with multiple chronic illnesses, including congestive heart failure, COPD, diabetes and asthma. These members had disproportionately high rates of hospital stays and expensive healthcare services.
- From 2009 to 2011, the high risk members who participated in PCMHs had more than 17% fewer hospital admissions then patients not treated in medical homes. This saved the health plan 11% in 2009 and almost 8% in 2010 on medical expenses.
Dive Insight:
PCMHs are demonstrating their worth, both in clinical and financial outcomes, but not consistently. While this study clearly led to positive results, others have found that the PCMH model didn't lead to lower costs or significantly higher quality of care. Critics argue that more research on PCMHs needs to be done, with scientific rigor, before we declare it the health model of the century. And it better be done soon—with 7,000 primary care practices officially accredited as PCMHs, we want to be sure they have the right guidance.