The Patient-Centered Medical Home’s Impact on Cost and Quality: Annual Review of Evidence, 2014-15
The Patient-Centered Medical Home (PCMH) is a model of primary care that is patient-centred, comprehensive, coordinated, accessible and committed to quality and safety. In the PCMH, the primary care team coordinates care for patients and guides them in their journeys across the health care system. In February 2016, the Patient-Centered Primary Care Collaborative, a not-for-profit membership organization, published a review titled "The Patient-Centered Medical Home's Impact on Cost and Quality", which provides a summary of PCMH cost and utilisation outcomes in the United States. The review includes peer-reviewed studies, state government evaluations, industry reports and independent federal program evaluations published between October 2014 and November 2015. According to the review, there is a clear trend showing that the PCMH leads to reductions in health care costs and/or unnecessary utilisation such as emergency department visits, inpatient hospitalizations and hospital re-admissions. The authors also discuss the impact of new developments in health system payment reform on PCMH, such as Medicare’s transition to value-based payments and passage of the Medicare Access and CHIP Reauthorization Act. The authors conclude that payment reform is necessary to sustain system-wide changes towards the PCMH model. However, due to increasing provider “measurement fatigue”, alignment of both payment and performance measurement across public and private payers is critical for gathering support from the primary care practices transitioning to value-based payment models.