title: Patient-centered medical home features and expenditures by medicare beneficiaries.
abstract: OBJECTIVE
  To determine the impact of individual features of the patient-centered medical home (PCMH) care model on next-year healthcare expenditures including outpatient, inpatient, emergency department, pharmacy, and total healthcare expenditures among Medicare beneficiaries 65 years and older.
  
  
  METHODS
  Analysis of retrospective longitudinal survey data. Methods Longitudinal files from the Medical Expenditure Panel Survey were analyzed. Differences in expenditures for individuals whose usual sources of care did or did not have different PCMH features were estimated using recycled predictions from generalized linear regression models.
  
  
  RESULTS
  Having little to no difficulty contacting the regular source of care over the telephone during regular business hours was associated with significantly lower total and inpatient expenditures over the next year (differences of $2867 and $3736, respectively). Having a regular source of care with office hours at night or on weekends was associated with significantly lower outpatient, emergency department, and other expenditures (differences of $535, $103, and $328, respectively). Pharmacy expenditures were significantly higher for individuals whose usual source of care inquired about medications and treatments prescribed by other doctors (difference of $362).
  
  
  CONCLUSIONS
  This study points out the need to identify how individual PCMH features impact healthcare expenditures across different policy-relevant categories. Practices that have not fully adopted a PCMH model can still make progress in improving quality and controlling costs by adopting even some modest features of the PCMH model.
authors.affiliation: Department of Health Management and Policy, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107. E-mail: els0127@live.unthsc.edu.
authors.forename: Erica L
authors.initials: EL
authors.lastname: Stockbridge
authors.forename: Lindsey M
authors.initials: LM
authors.lastname: Philpot
authors.forename: José A
authors.initials: JA
authors.lastname: Pagán
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D016527:Drug Costs / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D006278:Medicare / Q000191:economics* / Q000458:organization & administration; D018802:Patient-Centered Care / Q000191:economics / Q000458:organization & administration*; D012189:Retrospective Studies; D014481:United States