Estimating the Costs of Primary Care Transformation Grants
The Nation’s health care system is currently undergoing a vast transformation with the goals of achieving higher quality, more accessible, and more efficient health care for all Americans. As part of the transformation, the Patient Protection and Affordable Care Act of 2010 described and incentivized several models of patient-centered, highly-coordinated care. The models include the patient-centered medical home (PCMH), a model of care that aims to transform the delivery of comprehensive primary care to children, adolescents, and adults. The focus of the PCMH is to improve population health through high-quality, accessible patient-centered care with an emphasis on care coordination and communication. Adoption of PCMH-type models by primary care practices is incentivized through Federal, State, and insurance company incentive payments. A number of local, State, and national PCMH recognition and accreditation programs are available.
An emerging body of scientific evidence suggests that PCMHs and similar models are saving money by reducing hospital and emergency department visits, reducing health disparities, and improving patient outcomes. A small number of studies have found that the economic costs of transforming primary care practices to such models can be significant. However, it is believed that over time the adoption of a PCMH-type delivery system can help sustain lower costs of delivering care. To expand the body of evidence, the Agency for Healthcare Research and Quality (AHRQ) funded 15 Estimating the Costs of Supporting Primary Care Practice Transformation (Estimating Costs) grants to estimate the costs of supporting primary care transformation. These grants examined the costs of primary care transformation for a wide range of primary care settings and included a range of practice changes and stages of primary care transformation.
The Practical Guide was developed based on the experiences and lessons learned from the 15 AHRQ Estimating Costs grants. Final reports for these grants were reviewed when available.