Value and the medical home: effects of transformed primary care.
Am J Manag Care
; 16(8): 607-14, 2010 Aug.
Article
en En
| MEDLINE
| ID: mdl-20712394
ABSTRACT
BACKGROUND:
The primary care medical home has been promoted to integrate and improve patient care while reducing healthcare spending, but with little formal study of the model or evidence of its efficacy. ProvenHealth Navigator (PHN), an intensive multidimensional medical home model that addresses care delivery and financing, was introduced into 11 different primary care practices. The goals were to improve the quality, efficiency, and patient experience of care.OBJECTIVE:
To evaluate the ability of a medical home model to improve the efficiency of care for Medicare beneficiaries. STUDYDESIGN:
Observational study using regression modeling based on preintervention and postintervention data and a propensity-selected control cohort.METHODS:
Four years of claims data for Medicare patients at 11 intervention sites and 75 control groups were analyzed to compute hospital admission and readmission rates, and the total cost of care. Regression modeling was used to establish predicted rates and costs in the absence of the intervention. Actual results were compared with predicted results to compute changes attributable to the PHN model.RESULTS:
ProvenHealth Navigator was associated with an 18% (P <.01) cumulative reduction in inpatient admissions and a 36% (P = .02) cumulative reduction in readmissions across the total population over the study period.CONCLUSIONS:
Investing in the capabilities of primary care practices to serve as medical homes may increase healthcare value by improving the efficiency of care. This study demonstrates that the PHN model is capable of significantly reducing admissions and readmissions for Medicare Advantage members.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Calidad de la Atención de Salud
/
Eficiencia Organizacional
/
Atención Dirigida al Paciente
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Manag Care
Asunto de la revista:
SERVICOS DE SAUDE
Año:
2010
Tipo del documento:
Article
País de afiliación:
Estados Unidos