Apr 8, 2015
Does not include Appendixes
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RAND conducted an independent evaluation of the Federally Qualified Health Center (FQHC) Advanced Primary Care Practice (APCP) Demonstration for the Centers for Medicare and Medicaid (CMS). The evaluation studied the processes and challenges involved in transforming FQHCs into patient-centered medical homes (PCMHs) and assessed the effects of the FQHC APCP Demonstration model on access, quality, and cost of care provided to Medicare and Medicaid beneficiaries served by FQHCs.
The evaluation sought to answer three key policy questions: How does the demonstration affect practice structure and medical home recognition? Do demonstration sites deliver better beneficiary processes and outcomes than comparison sites? How does medical home recognition affect beneficiary processes and outcomes?
RAND used a mixed-methods approach to address these questions. This report presents the final results of RAND's analyses.
Medical Home Recognition
FQHC Use of Demonstration Funding and Other Financial Resources to Support PCMH Recognition
FQHC Use of Technical Assistance and Feedback Reports to Support PCMH Recognition
Demonstration Effect on Medical Home Recognition
Pathways to Medical Home Recognition
Change Management: Challenges and Facilitators
Provider and Staff Experience of Change
Effects of the Demonstration on Utilization, Care Processes, and Spending
Effect of the Demonstration on Patient Experience
The Relationship Between Medical Home Recognition and Changes in Beneficiary Processes and Outcomes
The Effects of Medical Home Recognition on Beneficiary Utilization, Processes, and Spending
The Effects of Medical Home Recognition on Beneficiary-Reported Experiences
The Effect of Alternative PCMH Recognition Types on Claims-Based Outcomes
Intensity of Change and Remaining Transformation