title: Total cost of care lower among Medicare fee-for-service beneficiaries receiving care from patient-centered medical homes.
abstract: OBJECTIVE
  To compare health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition.
  
  
  METHODS
  Medicare Part A and B claims files from July 1, 2007 to June 30, 2010, 2009 Census, 2007 Health Resources and Services Administration and CMS Utilization file, Medicare's Enrollment Data Base, and the 2005 American Medical Association Physician Workforce file.
  
  
  METHODS
  This study used a longitudinal, nonexperimental design. Three annual observations (July 1, 2008-June 30, 2010) were available for each practice. We compared selected outcomes between practices with and those without NCQA PCMH recognition.
  
  
  METHODS
  Individual Medicare fee-for-service (FFS) beneficiaries and their claims and utilization data were assigned to PCMH or comparison practices based on where they received the plurality of evaluation and management services between July 1, 2007 and June 30, 2008.
  
  
  RESULTS
  Relative to the comparison group, total Medicare payments, acute care payments, and the number of emergency room visits declined after practices received NCQA PCMH recognition. The decline was larger for practices with sicker than average patients, primary care practices, and solo practices.
  
  
  CONCLUSIONS
  This study provides additional evidence about the potential of the PCMH model for reducing health care utilization and the cost of care.
authors: The University of North Carolina at Greensboro, 1400 Spring Garden Street, Greensboro, NC, 27412.
authors: Martijn
authors: M
authors: van Hasselt
authors: Nancy
authors: N
authors: McCall
authors: Vince
authors: V
authors: Keyes
authors: Suzanne G
authors: SG
authors: Wensky
authors: Kevin W
authors: KW
authors: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018588:Fee-for-Service Plans; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016344:Medicare Part A / Q000191:economics*; D016345:Medicare Part B / Q000191:economics*; D008875:Middle Aged; D009735:Nursing Homes / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000191:economics*; D014481:United States
keywords: Medicare payments; Patient-centered medical home; health care utilization