Commonwealth Fund reports Colorado medical home pilot reduced ED use and costs

According to a Commonwealth Fund study, a multipayer medical home program piloted in Colorado led to a sustained reduction in emergency department use and costs over three years, although there were no overall cost savings for practices or patients. Primary care visits also decreased. The impact on quality was mixed: cervical cancer screening rates improved, yet colon cancer screenings and hemoglobin testing for diabetes patients decreased.

The goal of Patient Centered Medical Homes (PCMH) are to deliver primary care services in a proactive, coordinated manner and improve quality of care, including patient health outcomes– particularly those with multiple or complex care needs.  In addition, the PCMH goal is to lower by reducing the need for expensive hospital stays and emergency department visits.

The Commonwealth Fund research evaluated a pilot program involving 15 PCMH practices in Colorado serving approximately 98,000 patients both prior to the program’s launch and then again at two and three years.

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Study finds Medical Home experiment failed to show savings

According to Kaiser Health News, A new RAND study found that a $57 million experiment to deliver better, more efficient care at federally funded health centers struggled to meet its goals and is unlikely to save money.

The test to coordinate treatment for high-risk Medicare patients in hundreds of communities was one of many demonstrations run by the Department of Health and Human Services’ innovation center.

The Affordable Care Act created the lab and gave it $10 billion over a decade to test new ways to improve care and save money.

As the trial wound down last fall, 69 percent of the clinics that hadn’t dropped out had obtained full accreditation as “medical homes” — primary care practices that coordinate care across the maze of specialists, hospitals and emergency rooms.  HHS had hoped for 90 percent.
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