Although the patient-centered medical home is a promising model of care, more studies are needed to assess its effectiveness
Although the patient-centered
medical home (PCMH) is a
promising model of care, rigorous
evaluations and analysis are needed
to assess its effectiveness and refine
the model to meet stakeholders'
needs, concludes a review of
studies on the topic. Most (93
percent) health care consumers
want to have a single place or
doctor to provide primary care and
coordinate with any specialists.
However, only half report having
such an experience, according to
recent surveys. Decisionmakers are
aware of consumers' interest, but
need to consider whether the
evidence supports investing in
restructuring care to the PCMH
model to achieve better quality,
improved experience, and lower
cost of care.
Researchers at the Agency for
Healthcare Research and Quality
(AHRQ), Janice L. Genevro, Ph.D.,
Michael L. Parchman, M.D., and
David S. Meyers, M.D., along with
colleagues from Mathematic Policy
Research, conducted the literature
review of 498 studies published or
disseminated from January 2000 to
September 2010. Of these, 14
evaluations of 12 interventions were
judged to be rigorous. The
interventions most often cited to
support the medical home were
viewed as precursors to the medical
home. Evaluation of six of these
interventions provided rigorous
evidence on at least one of the three
outcome areas: quality, cost and
service use, and experience of care.
Overall, the evidence on the PCMH
provides some favorable effects on
all of the outcomes of interest and a
few unfavorable effects on costs.
Yet, most results were inconclusive.
Further, most of the existing
interventions targeted older, sicker
populations, who showed more
favorable effects that did general
populations. The study was funded
by the Agency for Healthcare
Research and Quality (Contract No.
More details are in "Early
evaluations of the medical home:
Building on a promising start," by
Deborah Peikes, Ph.D., Aparajita
Zutshi, Ph.D., Janice L. Genevro,
Ph.D., and others in the February
2012 American Journal of
Managed Care 18(2), pp. 105-116.
Reprints (Publication No. 12-R032)
are available from the AHRQ Publications Clearinghouse.
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