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Relationship of Clinic Medical Home Scores to Health Care Costs

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

Journal of Ambulatory Care Management: January/March 2011 - Volume 34 - Issue 1 - p 78–89
doi: 10.1097/JAC.0b013e3181ff6fd2
Issue on the Medical Home: Original Article

Multilevel, multivariate models examined the relationship between Primary Care Medical Home (PCMH) practice systems as measured by the Physician Practice Connections®-Readiness Survey™ (PPC®-RS™) and costs (total, outpatient, and inpatient) using 2008 patient data from 21 primary care clinics. Overall, PPC-RS scores were associated with insignificant changes in total (-$75/person, 1.1%) outpatient (-$67/person, 1.2%), and inpatient ($68/person, 0.5%) costs. However, improved PPC-RS scores were associated with significant decreases in total ($2378, 4.4%) and outpatient ($1282/person, 3.5%) costs among patients with 11 or more prescriptions suggesting higher functioning PCMHs may lead to reduced costs among the most complex and costly patients.

HealthPartners Research Foundation (Drs Flottemesch and Solberg and Mr Asche); University of Minnesota (Dr Fontaine), Minneapolis, Minnesota.

Corresponding Author: Thomas J. Flottemesch, PhD, HealthPartners Research Foundation, PO Box 1524, MS 21111R; Minneapolis, MN 55440–1524 (Thomas.J.Flottemesch@healthpartners.com).

We are grateful for funding for this study by AHRQ and for the helpful review and comments by David Lanier at AHRQ. In addition, we would like to thank Dr Greg Pawlson, MD at NCQA for his helpful comments. Finally, we are enormously indebted and grateful to our colleagues in various positions at HealthPartners who have helped in the collection and understanding of the various data elements used in these analyses. That includes Ann Hanson, Beth Averbeck, Nancy Salazar, Krista Van Vorst, Sue Gentilli, Gary Kitching, Katrina Beckstrom, Sarah Horst Evans, Penny Moran, Rosemary Costa, and Ann Harste.

Supported by the Agency for Healthcare Research and Quality.

Contract no. HHSA290 2007 10010 TO 4.

© 2011 Lippincott Williams & Wilkins, Inc.