title: Worksite medical home: health services use and claim costs.
abstract: OBJECTIVE
  To examine the relationship among use of an on-site employer-provided primary care medical home, and health services use and health plan costs for inpatient and outpatient services and pharmaceuticals.
  
  
  METHODS
  The study was a retrospective observational analysis of health plan claims, human resources data, and Health Care Center (HCC) encounters.
  
  
  METHODS
  Three years of data for employees and dependents designating the HCC as their primary care provider (HCC major users) were compared with data from 2 comparison groups: "casual" HCC users and HCC nonusers. The outcomes of interest were: 1) health services utilization, and 2) monetized use of the health plan. Secondary data from an employer-provided Health Care Center (HCC).
  
  
  RESULTS
  After adjusting for several potential confounders, HCC major users had less use of external healthcare services than the comparison groups (employees had 2.7 fewer external encounters than HCC casual users [P < .001] and 1.2 fewer external encounters than nonusers [P < .001]; dependents had 3.5 fewer external encounters than HCC casual users [P < .001] and 1.9 fewer external encounters than non-users [P < .001]). Annual monetized use of the health plan for employees and dependents was highest for HCC casual users relative to HCC major users (employees: $482 greater, P < .01; dependents: $598 greater, P < .001).
  
  
  CONCLUSIONS
  Employees and their dependents who were "casual users" of the HCC had the highest claims costs and use of outside healthcare services. Additional research is needed to assess the extent to which employees' utilization of services at on-site primary care medical homes affects employee health outcomes, resulting in potential effects on company healthcare plan expenditures, worker productivity, and return on investment.
authors: Christopher
authors: C
authors: Conover
authors: Duke University, DUMC Box 2713, Durham, NC 27710. E-mail: rebecca.brouwer@duke.edu.
authors: Rebecca
authors: R
authors: Namenek Brouwer
authors: Gale
authors: G
authors: Adcock
authors: David
authors: D
authors: Olaleye
authors: John
authors: J
authors: Shipway
authors: Truls
authors: T
authors: Østbye
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006264:Health Benefit Plans, Employee / Q000191:economics / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D009790:Occupations; D018802:Patient-Centered Care / Q000191:economics / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data; D044469:Racial Groups; D012189:Retrospective Studies; D017132:Workplace; D055815:Young Adult