The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model

March 2013
AHRQ Publication No. 12(14)-0020-1-EF
Prepared For:
Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov

Contract Numbers: HHSA290200900019I/HHSA29032002T, HHSA290200900019I/HHSA29032005T
Prepared By: Mathematica Policy Research, Princeton, NJ; Aparajita Zutshi, Ph.D., Deborah Peikes, Ph.D., M.P.A., Kimberly Smith, Ph.D., M.P.A., Melissa Azur, Ph.D. (Mathematica Policy Research),  Janice Genevro, Ph.D., Michael Parchman, M.D., David Meyers, M.D. (Agency for Healthcare Research and Quality).
Table 3. Evaluation designs and outcomes of the 12 interventions
 Cost and Service Use 
  Quality of CareCostService UseExperience
Intervention NameEvaluation DesignHealth OutcomesMortalityProcesses of CareIntervention WithoutIntervention WithHospital UseED UsePatientCaregiverProfessional

Notes: Table 1 contains the references for each intervention.

Health outcomes include measures of functioning, quality of life, and self-rated health status.
Processes of care include measures such as proportion of patients with controlled blood pressure, or with preventable hospitalizations.
Professional experience includes the experience of staff and other health care professionals.

aThe main study design was a cluster randomized, controlled trial, but professional experience was examined only for intervention group providers using a cross-sectional study.

bThe main study design was a randomized, controlled trial, but professional experience was examined only for intervention group providers using a pre-post study.

Aetna’s Embedded Case ManagersUnknown due to limited information  Yes  Yes   Yes
Care Management PlusComparison group design YesYes  YesYes   
Community Care of North Carolina (Evaluation 1, Domino, Humble, Lawrence, et al., 2009)Comparison group design   YesYesYesYes   
Community Care of North Carolina (Evaluation 2, Ricketts, Greene, Silberman, et al., 2004)Comparison group design   YesYesYesYes   
Community Care of North Carolina (Evaluation 3, Lodh, 2005)Unknown due to limited information   YesYes     
Geisinger Health System ProvenHealth NavigatorComparison group design   Yes Yes    
Geriatric Resources for Assessment and Care of EldersCluster RCTaYesYesYesYesYesYesYes  Yes
Group Health Cooperative Medical HomeComparison group design  YesYesYesYesYesYes Yes
Guided CareCluster RCT   YesYesYesYesYesYesYes
Improving Mood—Promoting Access to Collaborative Treatment for Late-Life DepressionRCTbYes YesYesYes  Yes Yes
Merit Health System and Blue Cross Blue Shield (BCBS) of North Dakota Chronic Disease Management PilotComparison group design  YesYes YesYes   
Pediatric Alliance for Coordinated CarePre-post design     YesYesYes  
Pennsylvania Chronic Care InitiativePre-post designYes YesYes YesYes   
Veterans Affairs Team-Managed Home-Based Primary CareRCTYes  YesYesYes YesYes