Enhancing the Medical Homes Model for Children With Asthma

Abstract

Our results indicate that enhancement of PCCM programs is one way for Medicaid programs to improve care, but may require substantial investments by states.

Emergency Department and Inpatient Hospital Use by Medicare Beneficiaries in Patient-Centered Medical Homes

“…[17][18][19][20][21] Two of the 3 trials reporting data on outpatient ED use showed a reduction; both of those populations included older adults similar to the Medicare population. 15,16 When data from these 2 studies were combined, the relative risk reduction in ED use was 0.81 (95% CI 0.67 to 0.98), similar to the magnitude of our observed reductions. Across 5 clusterrandomized studies reporting data on inpatient hospitalizations, none found a significant effect on inpatient hospitalization rates.…”

“…We were also not able to assess a practice's investment in becoming a patient-centered medical home, which can be substantial; therefore, we were not able to assess any net financial effect of patient-centered medical home transformation. 15 …”

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.…”

“…Because CCNC networks and primary care providers receive a permember-per-month (PMPM) payment from Medicaid to coordinate the health and disease management needs of the enrolled population, patients were considered to be enrolled in the CCNC program (and thus to have a PCMH) when both the network and the provider management fees were paid on a monthly basis. We identified the PMPM payment using state-defined procedure codes (W9920 or W9921 for the provider and W9923 for the network) [14]. A binary variable representing patients who had any CCNC enrollment during the 15-month postdiagnosis period served as the primary independent variable.…”

Is Medical Home Enrollment Associated With Receipt of Guideline-Concordant Follow-up Care Among Low-Income Breast Cancer Survivors?

“…14,15 In NC and elsewhere, medical homes have been shown to improve disease management, ensure receipt of general preventive services, reduce the risks of medication contraindications, reduce health disparities, and create efficiency gains. 16,17 Moreover, medical homes may be useful in improving cancer survivorship care, given that the management of cancer survivors requires coordination of multiple medications, providers, and procedures to ensure optimal cancer follow-up and management of noncancer health care needs. [18][19][20][21] Community Care of North Carolina (CCNC) is an innovative medical home program initiated in the 1990s to enhance primary care case management in vulnerable populations insured by Medicaid.…”