Can a Patient-Centered Medical Home Lead to Better Patient Outcomes? The Quality Implications of Geisinger’s ProvenHealth Navigator

Abstract

One of the primary goals of the patient-centered medical home (PCMH) is to provide higher quality care that leads to better patient outcomes. Currently, there is only limited evidence regarding the ability of PCMHs to achieve this goal. This article demonstrates the effect of PCMHs in improving certain clinical outcomes, as shown by the ProvenHealth Navigator (PHN), an advanced PCMH model developed and implemented by Geisinger Health System. In this study, the authors examined the claims data from Geisinger Health Plan between 2005 and 2009 and estimated the effect of PHN on reducing amputation rates among patients with diabetes, end-stage renal disease, myocardial infarction, and stroke. The results show that, despite its relatively short period of existence, PHN has led to significant improvements in certain outcomes, further illustrating its potential as a care delivery model to be adopted on a wider scale.

Health Care Utilization From Chemotherapy-Related Adverse Events Among Low-Income Breast Cancer Patients

“…PCMHs have proven to be effective in improving outcomes for patients with chronic diseases such as asthma, diabetes, and cardiovascular conditions [14,[31][32][33]. As we have reported elsewhere [10], breast cancer survivors who were enrolled in CCNC were significantly more likely to receive guideline-concordant follow-up care.…”

Improving Patient Experience by Transforming Primary Care: Evidence from Geisinger's Patient-Centered Medical Homes

“…[1][2][3][4] Moreover, the redesign and reinvigoration of primary care is spreading. National Committee for Quality Assurance (NCQA) reports that, by the end of 2010, more than 7600 clinicians at more than 1500 practices across the United States have been awarded NCQA's PCMH recognition.…”

Nephrology Care in a Fully Integrated Care Model

“…The implementation of the PHN within Geisinger has had significant clinical and financial benefits. Healthcare Effectiveness Data and Information Set performance measures are significantly better in most categories over that seen in non-PHN sites (Geisinger Health Plan, unpublished data); admission and readmission rates are better than that experienced in non-PHN sites (21), risk declined for microvascular complications of amputation and ESRD (22), and the return on investment has been positive and with a progressive upward trend (23). The nephrology group and the system's CKD population have been aided by the care gap measures and the CKD bundle of the PHN as mentioned above.…”