What Do You Mean by Medical Home?

Field: Health Professions (Health Sciences)

Editorials15 March 2016What Do You Mean by Medical Home?Mark W. Friedberg, MD, MPPMark W. Friedberg, MD, MPPFrom RAND Corporation, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-0058 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Keeping up with the medical home is hard work. Researchers have published dozens of studies on medical homes over the past few years, and with the proliferation of medical home initiatives, we can expect many more (1). To complicate matters, these studies frequently disagree with each other. Some have found that medical homes have modest or no effects, whereas others have found desirable changes in quality, utilization, and costs of care. How can readers make sense of a rapidly expanding and apparently conflicted literature?To better understand the contribution of each new medical home study, I suggest first asking, “What ...References1. Edwards ST, Bitton A, Hong J, Landon BE. Patient-centered medical home initiatives expanded in 2009-13: providers, patients, and payment incentives increased. Health Aff (Millwood). 2014;33:1823-31. [PMID: 25288429] doi:10.1377/hlthaff.2014.0351 CrossrefMedlineGoogle Scholar2. Friedberg MW, Lai DJ, Hussey PS, Schneider EC. A guide to the medical home as a practice-level intervention. Am J Manag Care. 2009;15:S291-9. [PMID: 20088633] MedlineGoogle Scholar3. van Hasselt M, McCall N, Keyes V, Wensky SG, Smith KW. Total cost of care lower among Medicare fee-for-service beneficiaries receiving care from patient-centered medical homes. Health Serv Res. 2015;50:253-72. [PMID: 25077375] doi:10.1111/1475-6773.12217 CrossrefMedlineGoogle Scholar4. Paustian ML, Alexander JA, ElReda DK, Wise CG, Green LA, Fetters MD. Partial and incremental PCMH practice transformation: implications for quality and costs. Health Serv Res. 2014;49:52-74. [PMID: 23829322] doi:10.1111/1475-6773.12085 CrossrefMedlineGoogle Scholar5. Romaire MA, Bell JF. The medical home, preventive care screenings, and counseling for children: evidence from the Medical Expenditure Panel Survey. Acad Pediatr. 2010;10:338-45. [PMID: 20675211] doi:10.1016/j.acap.2010.06.010 CrossrefMedlineGoogle Scholar6. Kern LM, Edwards A, Kaushal R. The patient-centered medical home and associations with health care quality and utilization. A 5-year cohort study. Ann Intern Med. 2016;164:395-405. doi:10.7326/M14-2633 LinkGoogle Scholar7. Friedberg MW, Schneider EC, Rosenthal MB, Volpp KG, Werner RM. Association between participation in a multipayer medical home intervention and changes in quality, utilization, and costs of care. JAMA. 2014;311:815-25. [PMID: 24570245] doi:10.1001/jama.2014.353 CrossrefMedlineGoogle Scholar8. Rosenthal MB, Friedberg MW, Singer SJ, Eastman D, Li Z, Schneider EC. Effect of a multipayer patient-centered medical home on health care utilization and quality: the Rhode Island Chronic Care Sustainability Initiative pilot program. JAMA Intern Med. 2013;173:1907-13. [PMID: 24018613] doi:10.1001/jamainternmed.2013.10063 CrossrefMedlineGoogle Scholar9. Friedberg MW, Rosenthal MB, Werner RM, Volpp KG, Schneider EC. Effects of a medical home and shared savings intervention on quality and utilization of care. JAMA Intern Med. 2015;175:1362-8. [PMID: 26030123] doi:10.1001/jamainternmed.2015.2047 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From RAND Corporation, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0058.Corresponding Author: Mark W. Friedberg, MD, MPP, RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA 02115; e-mail, [email protected]org.This article was published at www.annals.org on 16 February 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Patient-Centered Medical Home and Associations With Health Care Quality and Utilization Lisa M. Kern , Alison Edwards , and Rainu Kaushal Metrics Cited byPatient-Centered Medical HomeAssociation of High-Cost Health Care Utilization With Longitudinal Changes in Patient-Centered Medical Home ImplementationPatient-Centered Medical HomePayment and Care for Hematopoietic Cell Transplantation Patients: Toward a Specialized Medical Home for Complex Care PatientsEstimating Associations Between Medical Home Adoption, Utilization, and QualityThe Medical Home at 50: Are Children With Medical Complexity the Key to Proving Its Value?Synthesis Of Research On Patient-Centered Medical Homes Brings Systematic Differences Into Relief 15 March 2016Volume 164, Issue 6Page: 444-445KeywordsDisclosureEmergency departmentHealth careHealth care quality assessmentHealth care utilizationHospitalizationsIntent to treat analysisMotivationPatientsResearch laboratories ePublished: 16 February 2016 Issue Published: 15 March 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. 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