The Impact of Patient Centered Medical Homes on Medication Adherence

Guy David, Health Care Management, The Wharton School; Philip Saynisch, Harvard Business School; Aaron Smith-McLallen, Independence Blue Cross; and Spencer Luster, Harvard Medical School

Health Economics, Volume 27, Issue 11, November 2018

Abstract: Accreditation of providers helps resolve the pervasive information asymmetries in health care markets. However, meeting accreditation standards typically involves flexibility in implementation, leading to heterogeneity in performance. For example, the patient‐centered medical home (PCMH) is a leading model for recognizing high‐performing primary care practices. Flexibility in PCMH implementation allows for varying degrees of emphasis on processes designed to enhance medication adherence. To assess the impact of the PCMH on adherence, we combine 6 years of detailed patient claims data with a novel dataset containing detailed practice‐level PCMH attributes. We study the effects of the number and configuration of adherence‐relevant capabilities, using variation in the timing of PCMH adoption to estimate its impact. While PCMH adoption improved overall medication adherence, when combining claims data with the unique recognition data detailing what PCMH capabilities were adopted, we find that these gains are concentrated among patients in practices that adopted more adherence‐relevant capabilities. Despite mixed evidence in the literature concerning costs and utilization, our results indicate that PCMH recognition improves medication adherence.

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