Medical homes are a simple, compelling idea: Give primary-care doctors resources to reduce preventable medical crises for diabetics, asthmatics and others with chronic illness, and it will reduce hospital visits, improve lives and save money.
But it’s not so easy in practice.
Two big experiments run by the Center for Medicare Medicaid Innovation have delivered mixed early results in enhancing primary care, two studies find. The programs reduced expensive hospital visits in some cases, but struggled to show net savings after accounting for their cost.
Consultants evaluated the first year’s results for the Comprehensive Primary Care Initiative, a four-year program in Colorado, New Jersey and several other states; and the Multi-Payer Advanced Primary Care Practice Demonstration, a three-year test in eight states including New York and Pennsylvania. The experiments are part of the Affordable Care Act.
The CPC initiative cut costs by $168 per participating Medicare beneficiary, thanks largely to declines in hospital admissions and emergency visits, compared with results from practices that are not part of the initiative. Results were “more favorable than might be expected” in the test’s first year, said a report by Mathematica Policy Research.
But that wasn’t enough to cover the extra $240 per patient that the Department of
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