Healthcare payment reform is needed for the patient-centered medical-home model to be sustainable, according to a report published online by the Journal of the American Medical Association. The model leads to higher operating costs, and most of the savings generated though reduced hospital admissions and emergency-department visits benefit payers rather than providers, researchers concluded.
Researchers from the University of Chicago studied survey results from 669 of the 1,009 community health centers funded by the U.S. Health Resources and Services Administration and compared their adoption of medical-home principles—such as enhanced care access and communication, care management and patient tracking—with 2009 cost figures obtained from HRSA Uniform Data System reports. (Health centers not included in the study either did not participate in the survey or submitted incomplete results.) At the centers surveyed, 5,966 physicians cared for more than 12.5 million patients in 2009.
According to the report, the median operating cost per physician was $1.24 million. The median operating cost per patient per month was $47. The median cost per visit was $130.
The researchers rated the centers' implementation level of medical-home principles on a zero-to-100 scale. Scores ranged from a low of 21 to a high of 90, with an average of 60. Having a score of 70, or 10 points higher than the average, was associated with a $2.26 higher cost per patient per month.