Patient Experience with the Patient-Centered Medical Home in Michigan's Statewide Multi-Payer Demonstration: A...

Area of Science:

• Health Services Research
• Primary Care Transformation
• Patient Experience Measurement

Background:

• Existing literature on patient-centered medical homes (PCMHs) and patient experience shows mixed results.
• Multi-payer PCMH initiatives are being promoted to standardize requirements and enhance practice transformation.
• The Michigan Primary Care Transformation (MiPCT) project was a multi-payer demonstration initiative.

Purpose of the Study:

• To determine if PCMHs are associated with improved patient experience.
• To assess if a mature, multi-payer PCMH demonstration further enhances patient experience.

Main Methods:

• Cross-sectional comparison of adult patients within MiPCT PCMH, non-participating PCMH, and non-PCMH practices.
• Statistical controls for potential confounders in general and high-risk patient samples.
• Utilized the Clinician and Group Consumer Assessment of Healthcare Providers and Systems survey with supplemental PCMH questions.

Main Results:

• MiPCT patients reported significantly better experiences in access, communication, and coordination compared to non-PCMH patients.
• Significant improvements were also observed in self-management support and comprehensiveness for MiPCT patients.
• Non-participating PCMH ratings were intermediate, suggesting a dose-response relationship with PCMH maturity.

Conclusions:

• PCMH practices are linked to more positive patient experiences, particularly in domains of advanced primary care.
• Mature, multi-payer PCMH models show the strongest association with enhanced patient experience.
• Consistent expectations, resources, and time are crucial for successful practice transformation in PCMH initiatives.