title: Impact of a patient-centered medical home on access, quality, and cost.
abstract: BACKGROUND
  Patient-centered medical homes (PCMHs) are intended to actively provide effective care by physician-led teams, where patients take a leading role and responsibility.
  
  
  OBJECTIVE
  To determine whether the Walter Reed PCMH has reduced costs while at least maintaining if not improving access to and quality of care, and to determine whether access, quality, and cost impacts differ by chronic condition status.
  
  
  METHODS
  This study conducted a retrospective analysis using a patient-level utilization database to determine the impact of the Walter Reed PCMH on utilization and cost metrics, and a survey of enrollees in the Walter Reed PCMH to address access to care and quality of care.
  
  
  METHODS
  Inpatient and outpatient utilization, per member per quarter costs, Healthcare Effectiveness Data and Information Set metrics, and composite measures for access, patient satisfaction, provider communication, and customer service are included.
  
  
  RESULTS
  Costs were 11% lower for those with chronic conditions compared to 7% lower for those without. Since treating patients with chronic conditions is 4 times more costly than treating patients without such conditions, the vast majority of dollar savings are attributable to chronic care.
  
  
  CONCLUSIONS
  Results suggest focusing first on patients with chronic conditions given the greater potential for early gains.
authors.affiliation: Center for Naval Analyses, 4825 Mark Center Drive, Alexandria, VA 22311, USA.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Christensen
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Dorrance
authors.forename: Suneil
authors.initials: S
authors.lastname: Ramchandani
authors.forename: Sean
authors.initials: S
authors.lastname: Lynch
authors.forename: Christine C
authors.initials: CC
authors.lastname: Whitmore
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Borsky
authors.forename: Linda G
authors.initials: LG
authors.lastname: Kimsey
authors.forename: Linda M
authors.initials: LM
authors.lastname: Pikulin
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Bickett
mesh_terms: D002908:Chronic Disease; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008887:Military Medicine; D018802:Patient-Centered Care / Q000191:economics / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D014481:United States