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 4.2. Evaluations with ratings of low or excluded on all outcome
InterventionEvaluation DesignEvidence Rating: OutcomePrimary Rationale
Aetna’s Embedded Case ManagersUnknownExcluded: Hospital use; process of care; health care professional experienceLimited information on design and analysis reported
Community Care of North Carolina (Evaluation 1)Comparison group designLow: Costs, hospital use, and ED useIntervention and comparison groups did not have equivalent outcomes at baseline
Community Care of North Carolina (Evaluation 2)Comparison group designLow: Costs, hospital use, and, ED useStudy did not report if the intervention and comparison groups had equivalent outcomes at baseline
Community Care of North Carolina (Evaluation 3)UnknownExcluded: CostsLimited information on design and analysis reported
Group Health Cooperative Medical HomeComparison group designLow: Costs, hospital use, and ED use; process of care; patient experience of care; health care professional experienceSystematic confounding due to implementation in only one clinic
Merit Health System and Blue Cross Blue Shield (BCBS) of North Dakota Chronic Disease Management PilotComparison group designLow: Costs, hospital use, and ED use; process of careSystematic confounding due to implementation in only one clinic
Pediatric Alliance for Coordinated CarePre-post designLow: Hospital use and ED use; patient experience of careEvaluation design prevents attribution of changes in the outcome to the intervention rather than other factors
Pennsylvania Chronic Care InitiativePre-post designLow: Costs, hospital use, and ED use; health outcomes; process of careEvaluation design prevents attribution of changes in the outcome to the intervention rather than other factors