Medical home cost savings questioned

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Medical homes, a concept of fortifying primary care mainly for Medicaid enrollees in order to improve their health and returns on dollars spent, have come under fire in recent studies, Stateline Health News reported.

According to Stateline's review of the literature, only one study has definitively shown cost savings linked to the deployment of medical homes, and it didn't involve Medicaid enrollees.

That study, recently published in the American Journal of Managed Care (AJMC), scrutinized nearly 500 studies of medical home usage published between 2000 and 2010. It observed that "a number of promising healthcare interventions have been shown not to actually work when evaluated using rigorous methods."

The questions about medical homes arise as the Medicaid program is prepared to pay generous subsidies to encourage states to start up a hybrid called "health homes," Stateline reported.

Deborah Peikes of the Mathematica Policy Research organization and lead author of the AJMC study told Stateline, "My sense is that the medical home model is really promising. Some interventions have been able to reduce the number of hospitalizations and improved some health outcomes. But whether the program saves money is another question," she said.

Meanwhile, another study by the Milliman actuarial firm concluding that a medical home program in North Carolina saved nearly $1 billion between 2000 and 2007 has been questioned, according to Stateline. It noted that the AJMC study raised doubts about whether Milliman's analysis used adequate control groups.

To learn more:
- read the Stateline Health News article
- check out the AJMC medical home study
- here's the Milliman study executive summary (.pdf)
- read the Information Week article on the costs of medical home IT

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