High-risk patients within a patient-centered medical home model experienced lower costs and utilization rates, according to results of a three-year study published in The American Journal of Managed Care.
The study followed about 700 Independence Blue Cross of Pennsylvania patients, many of whom had multiple illnesses such as congestive heart failure, chronic obstructive pulmonary disease, diabetes or asthma. The patients were treated in primary care practices that had converted to PCMHs.
Patients cared for in the PCMHs had fewer hospital admissions than the control group: 10.8 percent fewer in 2009, 8.6 percent fewer in 2010 and 16.6 percent fewer in 2011. Additionally, compared to the control group, the high-risk PCMH group of patients saw total medical cost savings of 11.2 percent in 2009 and 7.9 percent in 2010. The cost reductions were driven by the lower hospitalization rates, according to the study.
While the PCMH model did benefit high-risk patients, costs and utilization did not differ significantly between the PCMH and control groups among all patients, "suggesting that the benefits of the PCMH model are concentrated among high-risk, high-cost patients," the authors wrote.
This study seems to refute a recently published RAND Corporation study, which found a PCMH pilot program led to few quality gains and had little effect on hospital utilization or cost of care.
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