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
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).
|Cost and Service Use|
|Quality of Care||Cost||Service Use||Experience|
|Intervention Name||Evaluation Design||Health Outcomes||Mortality||Processes of Care||Intervention Without||Intervention With||Hospital Use||ED Use||Patient||Caregiver||Professional|
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 Managers||Unknown due to limited information||Yes||Yes||Yes|
|Care Management Plus||Comparison group design||Yes||Yes||Yes||Yes|
|Community Care of North Carolina (Evaluation 1, Domino, Humble, Lawrence, et al., 2009)||Comparison group design||Yes||Yes||Yes||Yes|
|Community Care of North Carolina (Evaluation 2, Ricketts, Greene, Silberman, et al., 2004)||Comparison group design||Yes||Yes||Yes||Yes|
|Community Care of North Carolina (Evaluation 3, Lodh, 2005)||Unknown due to limited information||Yes||Yes|
|Geisinger Health System ProvenHealth Navigator||Comparison group design||Yes||Yes|
|Geriatric Resources for Assessment and Care of Elders||Cluster RCTa||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes|
|Group Health Cooperative Medical Home||Comparison group design||Yes||Yes||Yes||Yes||Yes||Yes||Yes|
|Guided Care||Cluster RCT||Yes||Yes||Yes||Yes||Yes||Yes||Yes|
|Improving Mood—Promoting Access to Collaborative Treatment for Late-Life Depression||RCTb||Yes||Yes||Yes||Yes||Yes||Yes|
|Merit Health System and Blue Cross Blue Shield (BCBS) of North Dakota Chronic Disease Management Pilot||Comparison group design||Yes||Yes||Yes||Yes|
|Pediatric Alliance for Coordinated Care||Pre-post design||Yes||Yes||Yes|
|Pennsylvania Chronic Care Initiative||Pre-post design||Yes||Yes||Yes||Yes||Yes|
|Veterans Affairs Team-Managed Home-Based Primary Care||RCT||Yes||Yes||Yes||Yes||Yes||Yes|