The Impact of Primary Care Practice Transformation on Cost, Quality & Utilization

In the decade since the “Joint Principles of the Patient-Centered Medical Home”2 were published, it has become widely accepted that primary care practice transformation and delivery are essential to achieving the nation’s Quadruple Aim – improving patient and provider experience and the health of the population while decreasing cost. Over that same time span, evidence that lights the path towards transformation, of the sort best suited to accomplishing these aims and realizing high-performing primary care, continues to emerge.

As this year’s evidence report reaffirms, the Patient-Centered Medical Home (PCMH) has demonstrated improved outcomes in terms of quality, cost and utilization, but not uniformly. It also confirms important lessons for payers and policymakers: like any form of evolution, meaningful transformation takes time, is dynamic in nature, and displays considerable variations in quality, cost and utilization outcomes. The evidence also reveals some concrete modifications to the initial model, learned from best practice PCMHs over the past 10 years, which have improved primary care and its outcomes. For example, it is quite clear that team-based interventions, including case management, and having a usual source of care have positively impacted the patient experience. That said, there is no single ‘implementation manual’ that meets the needs of all.

Download pcmh_evidence_report_08-1-17-.pdf