Estimating provider and service costs at a community-based medical home project in central Ohio

This article describes a preliminary economic feasibility study estimating the costs involved in ensuring basic services and adequate provider capacity as a first step in creating a patient-centered medical home model in Franklin County, Ohio. The initial feasibility study estimated the costs involved in: 1) increasing the number of primary care providers in the county, 2) increasing care capacity at existing federally qualified health centers, and 3) increasing capacity to provide a set of comprehensive care services involving care coordination and availability of specialists and prescription drugs. Cost estimates based on providing services to children and adults below 400% of the federal poverty level in the county ranged from $2.4 million to $212.9 million, depending on the features included in each approach for ensuring adequate provider and service capacity. Major factors affecting the cost estimates included population characteristics, the supply of primary care providers (MD or non-MD), availability of prescription drug coverage, capacity at existing federally qualified health centers, and whether the medical home model involved expanding Medicaid eligibility and enrollment.