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Examining differential performance of 3 medical home recognition programs
Ammarah Mahmud1, Justin W Timbie, Rosalie Malsberger
1RAND Corporation, 1200 S Hayes St, Arlington, VA 22202.
The American Journal of Managed Care
|July 19, 2018
Summary
Different patient-centered medical home recognition programs show varied impacts on federally qualified health center patient outcomes and Medicare spending. NCQA Level 3 recognition was linked to improved quality and reduced costs, while TJC also showed benefits.
Area of Science:
- Health Services Research
- Primary Care Medicine
- Healthcare Quality Improvement
Background:
- Patient-centered medical homes (PCMH) aim to improve primary care delivery.
- Federally Qualified Health Centers (FQHCs) serve vulnerable populations.
- Multiple PCMH recognition programs exist, with varying standards.
Purpose of the Study:
- To compare patient outcomes associated with three PCMH recognition programs (NCQA Level 3, TJC, AAAHC) among Medicare beneficiaries in FQHCs.
- To assess the impact of PCMH recognition on healthcare utilization, quality, and expenditures.
Main Methods:
- Utilized data from the FQHC Advanced Primary Care Practice Demonstration.
- Employed propensity-weighted difference-in-differences analyses over three years.
- Compared outcomes for beneficiaries attributed to recognized vs. non-recognized FQHCs.
Main Results:
- All recognized FQHCs showed changes in utilization, quality, and expenditures compared to non-recognized sites.
- NCQA Level 3 recognition was associated with increased ambulatory visits, improved quality, and reduced hospitalizations and expenditures.
- TJC recognition was linked to reduced emergency department visits and hospitalizations.
- AAAHC recognition showed outcomes in the opposite direction of expectations.
Conclusions:
- Heterogeneous changes in patient outcomes by recognition type suggest differences in program criteria and processes.
- The choice of PCMH recognition program may influence its impact on FQHC performance and Medicare spending.
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