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Is Consistent Primary Care Within a Patient-Centered Medical Home Related to Utilization Patterns and Costs?

Fontaine, Patricia MD, MS; Flottemesch, Thomas J. PhD; Solberg, Leif I. MD; Asche, Stephen E. MA

Journal of Ambulatory Care Management: January/March 2011 - Volume 34 - Issue 1 - p 10–19
doi: 10.1097/JAC.0b013e3181ff7019
Issue on the Medical Home: Original Article

The patient-centered medical home (PCMH) is seen as an important vehicle for providing consistent primary care and achieving cost savings through care coordination. We used health plan administrative data to evaluate utilization and cost among enrollees who attended a PCMH compared with those who fragmented their care. Controlling for demographic differences, PCMH attendees made significantly fewer primary care and specialist visits than other groups, and associated professional fees were significantly lower than for enrollees receiving less consistent primary care.

Department of Family Medicine and Community Health, University of Minnesota School of Medicine (Dr Fontaine) and HealthPartners Research Foundation (Drs Flottemesch and Solberg and Mr Asche), Minneapolis, Minnesota.

Correspondence: Patricia Fontaine, MD, MS, Department of Family Medicine and Community Health, University of Minnesota School of Medicine, 717 Delaware St SE 424, Minneapolis, MN 55414 (fonta002@umn.edu).

Supported by the Agency for Healthcare Research and Quality, Contract no. HHSA290 2007 10010 TO 4.

We are grateful for the helpful review and comments by David Lanier at the Agency for Healthcare Research and Quality and Sarah Hudson Scholle at National Committee for Quality Assurance. In addition, we are enormously indebted and grateful to our colleagues at HealthPartners: Ann Hanson, Beth Averbeck, Nancy Salazar, Krista Van Vorst, Sue Gentilli, and Gary Kitching, who helped in the collection and understanding of the various data elements used in these analyses, and Ann Harste and Liz Greene, who assisted with planning and manuscript preparation.

© 2011 Lippincott Williams & Wilkins, Inc.