Model Homes: Evaluating Approaches to Patient-centered Medical Home Implementation

Philip A. Saynisch, National Committee for Quality Assurance; Guy David, Health Care Management, The Wharton School; Benjamin Ukert and Abiy Agiro, HealthCore Inc.; and Sarah H. Scholle and Tyler Oberlander, National Committee for Quality Assurance

Medical Care, March 2021

Abstract: The patient-centered medical home (PCMH) model has been widely adopted, but the evidence on its effectiveness remains mixed. One potential explanation for these mixed findings is variation in how the model is implemented by practices. PCMH adoption was associated with a >8% reduction in total expenditures. We find significant reductions in emergency department utilization and outpatient care, and both lab and imaging services. In our by-group results we find that while the reduction in outpatient care is significant across all 3 groups, the reduction in emergency department utilization is driven entirely by 1 group with enhanced electronic communications. The PCMH model has significant impact on patterns of health care utilization, especially when heterogeneity in implementation is accounted for in program evaluation.