New Study Finds Six Ways Patient-Centered Medical Homes Lower Medicare Spending

Researchers Found PCMHs That Used Clinical Data to Trigger Patient Reminders Saved About $70 Per Patient Per Month

RESEARCH TRIANGLE PARK, N.C. — The nonprofit research institute, RTI International, and its partner the Urban Institute published a new study in Annals of Family Medicine on elements of the patient-centered medical home (PCMH) model of care that are associated with lower Medicare spending and utilization among beneficiaries.

Researchers analyzed healthcare costs from PCMHs that took part in a 2011-2014 Centers for Medicare & Medicaid Services initiative to establish advanced primary care “medical homes” with improved and centralized care coordination. The analysis found six ways that some PCMHs lowered Medicare spending, hospitalizations, or emergency department visits by:

1. Using its patient clinical data to identify and remind patients due for preventive services;
2. Using its patient clinical records to initiate pre-visit planning, clinician reminders, targeted patient outreach, and population health monitoring;
3. Offering targeted consultations for patients with chronic conditions to set health goals;
4. Following patients during hospital stays and supporting other specialists in patient care;
5. Establishing a protocol for sharing information in medical referrals; and
6. Adopting systematic approaches to quality improvement.

“On average, PCMHs that used clinical data to trigger patient reminders for preventive services saved about $70 per patient per month, lowered acute care hospital spending, and reduced hospitalizations and emergency department visits in its patient population,” said Susan Haber, ScD, a study author and director of the Center for Health of Populations at RTI. “As healthcare continues to transition towards patient- and value-based care, understanding what works to deliver more efficient, cost-effective care benefits Medicare beneficiaries and taxpayers.”

Researchers analyzed the claims of 302,719 Medicare fee-for-service beneficiaries linked to 394 U.S. primary care practices. Through a regression analyses of changes in outcomes for Medicare beneficiaries in practices that engaged in particular PCMH activities compared with beneficiaries in practices that did not, the researchers drew conclusions on activities that saved money and reduced service utilization.

View or download a full copy of the study: https://www.annfammed.org/content/18/6/503