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Medical Homes Show Limited Quality Improvements, No Cost Reductions

February 27, 2014

Medical homes, or patient-centered medical homes, are primary care practices designed to provide comprehensive, personalized, team-based care.

Medical homes use patient registries, electronic health records, and other advanced capabilities. Recent initiatives have encouraged practices to invest in these new capabilities, participate in learning collaboratives, and achieve formal medical home recognition. (Health plans pay more to practices that achieve recognition.)

In theory, transforming primary care practices into medical homes will result in care that is better-managed, more cost-effective, and higher-quality—particularly for patients with chronic diseases.

However, a new study in the Journal of the American Medical Association (JAMA) suggests that medical home interventions may require further refinements before their full potential can be realized.

RAND's Mark Friedberg, who led the study, explained on the JAMA Report:

“[The medical home pilot practices we studied] improved on … diabetes care … [but] we did not see improvements on other measures of quality, like preventive screenings, and we did not see decreases in emergency department use, hospitalizations, or total cost of care.”

These practices may have had “some, but not all of the ingredients necessary” to reap more widespread benefits, said Friedberg. So evaluations like this—and others currently being conducted by RAND researchers—can help guide the improvement of the medical home model.

— Pete Wilmoth