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 9. Summary of evidence on cost
 Statistically SignificantInconclusive
InterventionFavorableUnfavorableNot Statistically SignificantUncertain Statistical Significance

Notes: A result is considered statistically significant if p<0.1. The effects reported here are point estimates; the true can lie anywhere within confidence intervals around these estimates, and may well be different from the point estimate. We do not include the confidence intervals because not all studies reported them.

aWe adjusted the p-values for clustering for findings on costs for the GRACE evaluation using a range of estimates of the intracluster correlation (ICC) from the literature. The findings remained statistically significant after the adjustment.

 

Geriatric Resources for Assessment and Care of EldersaYear 3: Reduced 23% among high-risk patientsYear 1: Increased 28% among all patients and 46% among low-risk patients
Year 2: Increased 14% among all patients and 30% among low-risk patients
Year 3: Increased 19% among low-risk patients
Year 1: High-risk patients
Year 2: High-risk patients
Year 3: All patients
 
Guided Care  8 months: All patients 
Improving Mood-Promoting Access to Collaborative Treatment for Late-Life Depression  4 years: All patients 
VA Team-Managed Home-Based Primary Care  Months 1–12: Increased 12%