Medical homes, which are often thought of as a better model of primary care with an emphasis on enhanced coordination, may not improve quality of treatment, according to a new study.
Medical homes, which are often thought of as a better model of primary care with an emphasis on enhanced coordination, may not improve quality of treatment, or help to save money, according to results from a recent study.
The study, recently released by the American Medical Association, evaluated the Southeastern Pennsylvania Chronic Care Initiative, one of the biggest and earliest medical home pilots in the country.
Over the course of the three-year pilot program, it was determined that medical homes in the initiative did not save money when compared with traditional primary care practices. The homes acquired bonuses of $92,000 per doctor over the span of three years.
In total, the study collected data from nearly 120,000 people. Patients in 32 small and medium-sized primary care practices, and with a total of four separate health plans were included in the study. Researchers compared these participants with patients in 29 separate practices who opted not to take part in the pilot.
The study found that patient health improved in just one out of every 11 measures. It also found that the patients did not use the hospital or emergency room any less, and that there were no dramatic cost savings.
Medical homes have increased in popularity following rising health care costs around the country, particularly for the aging population. Among the services that this type of care offers is a team led by doctors that focuses on complete and routine care that includes phone calls to remind patients to take their medications and to schedule follow-up visits. Along with doctors, care is also coordinated among nursing homes, specialists, and hospitals.
Dr. Mark Friedberg, lead author of the study and a RAND researcher, called the recent study results surprising.
“Expectations for the medical-home model were quite high and this was not consistent with previous findings,” said Friedberg.
Friedberg concludes, “There are folks who believe the medical home is a proven intervention that doesn’t even need to be tested or refined. Our findings will hopefully change those views.”
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