A three-year patient-centered medical home pilot program led to few quality gains and no reductions hospital utilization or total cost of care, a RAND Corporation study found.
The Southeastern Pennsylvania Chronic Care Initiative was a medical home pilot involving 32 primary care practices and six health plans that ran between 2008 and 2011. The study compared quality, utilization and costs between pilot practices and 29 nonpilot practices.
While pilot practices adopted medical home capabilities, like creating lists of patients overdue for care, and showed signs of quality improvement for aspects of diabetes care, there was no quality improvement for asthma care, cancer screening or control of diabetes, according to a news release.
Additionally, the pilot program was unsuccessful at lowering patient visits to hospitals or emergency departments, and there were no cost reductions.
Researchers did note that practices participating in the pilot program may have been more quality-minded than others prior to becoming a medical home, meaning there may not have been much room for quality improvement.
"The medical home has gained popularity as a new model of primary care, with the expectation that the approach will produce better and lower-cost healthcare," Mark Friedberg, MD, the study's lead author and a natural scientists at RAND, said in a release. "Our findings suggest that achieving all of these goals is a challenge."
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