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The price tag on a patient-centered medical home
Date:6/24/2012

The patient-centered medical home (PCMH) is a concept at the heart of many health care reform models that aim to both improve the quality of care and reduce wasteful spending. But a new analysis of federally qualified health centers finds that clinics with higher scores as medical homes also had higher per-patient operating costs.

The research, published online in the Journal of the American Medical Association and presented today at the AcademyHealth conference in Orlando, Fla., is the first national study to put a price on these additional costs.

"We're not saying that the medical home costs too much and we can't do it," said first author Robert Nocon, MHS, Senior Health Services Researcher at the University of Chicago Medicine. "Primary care providers today are being asked to implement a model and improve care in a way that will hopefully benefit patients and hopefully have a lot of good downstream impacts, but in a way that doesn't have downstream financial benefits for them. Instead, we need to build a system that promotes the care that we want to happen."

Patient-centered medical homes are clinics that provide access to comprehensive, high-quality primary care and case management. Research has shown that shifting patient care to these clinics can decrease health care spending by reducing hospitalizations and inappropriate emergency department use.

However, in the current system, most physicians will not benefit from these savings. Indeed, the new analysis suggests that many practices will incur additional expenses for turning a clinic into a true PCMH through spending on additional personnel, technology such as electronic health records, and quality improvement measures. The authors conclude that financial incentives must be designed to ensure that the PCMH model can be sustained.

"If policymakers want to have medical homes, then the current system is not set up to lead to that result," said co-autho
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Contact: Rob Mitchum
robert.mitchum@uchospitals.edu
773-795-5227
University of Chicago Medical Center
Source:Eurekalert

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