Patient-centered medical home implementation effects on emergency room utilization: a case study

The Patient-Centered Medical Home (PCMH) concept has been commended for its potential to increase access to primary care while improving quality and health outcomes. Numerous studies have documented the benefits of the PCMH healthcare delivery modality inclusive of decreased emergency room (ER) visits among PCMH enrollees. Yet a debate wages on whether PCMHs are conceptually sound and clinically effective with few empirical studies dedicated to the study of this relatively new care delivery model (Friedberg et al. 2014; Agency for Health Research and Quality 2012; Cassidy 2010). As part of the campaign to implement the PCMH care delivery modality throughout the Military Health System, the Army Medical Command constructed a medical home at Ft. Campbell, Kentucky, in December 2010. The authors evaluated the effectiveness of this medical home in reducing ER visits and found enrollees were 67% less likely than standard primary care clinic enrollees to visit the ER when controlling for age, gender, race, beneficiary category, marital status, and outpatient visits. Additionally, men were nearly half as likely as women to visit the ER, and high outpatient users were twice as likely to visit the ER. This is an encouraging study for proponents of the PCMH model. Limitations and suggestions for future research are also presented.