Higher health center operating costs were associated with clinics that had higher scores on a scale that assessed six aspects of the patient-centered medical home, according to a survey of health center administrators.
Patient-centered medical homes (PCMH) provide access to comprehensive primary care and case management. Shifting patient care to these facilities may decrease health care costs by reducing hospitalizations and inappropriate emergency department use
In a cross-sectional study of PCMH rating and operating costs in 2009, researchers assessed PCMH rating through surveys of 669 health center administrators. Survey scores ranged from zero (worst) to 100 (best) for total PCMH score as well as six subscales, including access/communication, care management, external coordination, patient tracking, test/referral tracking and quality improvement. Uniform Data System reports submitted to the Health Resources and Services Administration provided costs.
Overall, study results showed the average health center had a 10-point higher total PCMH score, which was associated with a $2.26 (4.6%) higher operating cost per patient per month. For the average patient population per clinic of 18, 753 patients, that translates to $508,207 in additional costs annually, according to the study.
“Primary care providers today are being asked to implement a model and improve care in a way that will benefit patients and hopefully have a lot of good downstream impacts, but in a way that doesn’t have downstream financial benefits for them,” Robert Nocon, MHS, senior health services researcher at the University of Chicago Medicine, said in a press release. “Instead, we need to build a system that promotes the care that we want to happen. If we don’t find ways to ensure that they can share in the financial benefits, it really is a risk to the sustainability of the entire model.”
For more information:
Nocon RS. JAMA. 2012;doi:10.1001/jama.2012.7048.
Disclosure: Nocon received financial support from the Commonwealth Fund, Merck and the Robert Wood Johnson Foundation.
