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Patient-centered medical homes in Louisiana had minimal impact on Medicaid population's use of acute care and costs.

Authors
  • Cole, Evan S1
  • Campbell, Claudia2
  • Diana, Mark L3
  • Webber, Larry4
  • Culbertson, Richard5
  • 1 Evan S. Cole ([email protected]) is an associate project director at the Georgia Health Policy Center, Georgia State University, in Atlanta. , (Georgia)
  • 2 Claudia Campbell is a professor of health systems management at the School of Public Health and Tropical Medicine, Tulane University, in New Orleans, Louisiana.
  • 3 Mark L. Diana is an associate professor of health systems management at the School of Public Health and Tropical Medicine, Tulane University.
  • 4 Larry Webber is a professor of biostatistics at the School of Public Health and Tropical Medicine, Tulane University.
  • 5 Richard Culbertson is a professor and director of health policy and systems management in the School of Public Health, Louisiana State University, in New Orleans.
Type
Published Article
Journal
Health affairs (Project Hope)
Publication Date
Jan 01, 2015
Volume
34
Issue
1
Pages
87–94
Identifiers
DOI: 10.1377/hlthaff.2014.0582
PMID: 25561648
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The patient-centered medical home model of primary care has received considerable attention for its potential to improve outcomes and reduce health care costs. Yet little information exists about the model's ability to achieve these goals for Medicaid patients. We sought to evaluate the effect of patient-centered medical home certification of Louisiana primary care clinics on the quality and cost of care over time for a Medicaid population. We used a quasi-experimental pre-post design with a matched control group to assess the effect of medical home certification on outcomes. We found no impact on acute care use and modest support for reduced costs and primary care use among medical homes serving higher proportions of chronically ill patients. These findings provide preliminary results related to the ability of the patient-centered medical home model to improve outcomes for Medicaid beneficiaries. The findings support a case-mix-adjusted payment policy for medical homes going forward. Project HOPE—The People-to-People Health Foundation, Inc.

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