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The impact of a regional patient-centered medical home initiative on cost of care among commercially insured population in the US

Authors Maeng DD, Sciandra JP, Tomcavage JF

Received 19 December 2015

Accepted for publication 7 March 2016

Published 26 May 2016 Volume 2016:9 Pages 67—74

DOI https://doi.org/10.2147/RMHP.S102826

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Mary Schmeida

Peer reviewer comments 4

Editor who approved publication: Professor Frank Papatheofanis

Daniel Dukjae Maeng, Joann P Sciandra, Janet F Tomcavage

Geisinger Health System, Danville, PA, USA

Abstract: The impact of a patient-centered medical home (PCMH) in reducing total cost of care remains a subject of debate, particularly among the non-elderly adult population. This study examines a 6-year experience of a large integrated regional health care delivery system in the US implementing PCMH among its commercially insured population. A regional health plan's claims data from 2008 through 2013 among its commercially insured members were obtained and analyzed. Over the 6-year period, the PCMH implementation beyond the first 6 months of exposure was associated with a lower total cost of care of ~9% (P<0.05). The largest reduction was observed in outpatient costs (12%; P<0.05). This study suggests that PCMH implementation among the non-elderly adult population can potentially lead to cost savings. Future studies are necessary to identify the drivers of the cost savings and examine if similar results can be replicated elsewhere by other health care delivery systems.

Keywords: patient-centered medical home, cost of care, commercially insured, non-elderly adults

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