Study: Multipayer medical home only reaped limited improvements


A multipayer patient-centered medical home pilot in Pennsylvania led to only limited improvements in quality and failed to reduce unnecessary medical utilization, according to an article published in the Journal of the American Medical Association.

The report analyzed the Southeastern Pennsylvania Chronic Care Initiative (PACCI), one of the earliest and largest multi-payer medical home pilots, to determine whether it has improved quality and reduced utilization and costs.

In the more than three years since launching, however, the PACCI hasn't significantly lowered utilization rates for hospitals, emergency departments or ambulatory care services.

The article suggested that the failure to boost quality, lower utilization and reduce costs could be caused by distractions, preventing the provider practices from focusing on activities that would have improved quality and efficiency of care. For example, the participating practices received early financial rewards for achieving recognition from the National Committee for Quality Assurance, which may have preoccupied the practices.

What's more, the six participating insurers, including three private plans and three Medicaid managed care plans, didn't incentivize the practices to lower costs or provide information related to their patients' care utilization rates.

This study seems to contradict other research findings, which have determined that medical homes do cut costs and improve care. For example, Independence Blue Cross lowered costs and utilization rates for high-risk members through its medical home; Horizon Blue Cross Blue Shield of New Jersey's medical home has reduced hospitalizations and increased preventive care; and Blue Cross Blue Shield of Michigan saved about $155 million in three years while also improving quality care, FierceHealthPayer previously reported.

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