Benefits of a ’s Medical Home A Literature Summary of 115 Articles | 2017 Update

ACCESS

ER VISITS & HOSPITALIZATIONS 7/8 studies showed 51/61 positive results Several studies studies showed specifically found fewer ER visits & hospitalizations in positive results COST SAVINGS with chronic .

PREVENTIVE CARE 27/34 studies showed 18/24 positive results studies showed positive results SATISFACTION QUALITY 19/22 studies showed positive results 19/24 Several studies have studies showed found that Patient's Medical positive results Home implementation improves both patient and provider satisfaction.

Evidence Summary - the benefits of the Patient’s Medical Home July 2017 Question What is the evidence supporting the concept of the Patient’s Medical Home (PMH)? Summary of findings

• Recent studies have found that with the implementation of a Patient’s Medical Home, practices have experienced several improved outcomes • Many of these changes occurred even in the early implementation stages, and were sustained and increased over time • For many outcomes, the greater the extent of PMH implementation or stage of maturity, the better the results (ED visits, quality, cost savings, prevention) • The experiences of special populations have been addressed in particular detail • See below for overall outcomes and themes • The numbers correspond with the numbered reference list below the summary • This 2017 update includes more detail on utilization outcomes, and the impact of the PMH on complex patients. • There is some variability in study quality, effect size, and in how the patient’s medical home is defined. Study quality has not been evaluated in this summary. • The majority of the studies are from the United States. • Please note bolded results reflect review articles that analyze multiple studies and may include peer reviewed articles and/or reports. As such, individual articles may be represented more than once. • Should you require further clarification, please email: [email protected].

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Patient’s Medical Home implementation has been associated with: • Fewer emergency visits & hospitalizations o 1, 2, 3, 4, 9, 10, 12, 14, 15, 16, 17, 19, 21, 22, 26, 27, 28, 30, 32, 34, 35, 40, 41, 42, 44, 46, 48, 49, 51, 52, 57, 59, 66, 68, 71, 76, 78, 79, 83, 84, 90, 91, 92, 94, 97, 98, 99, 100, 104, 106, 109 o Several studies specifically found fewer ER visits & hospitalizations in patients with chronic disease. 12, 26, 34, 40, 44, 46, 49, 59, 76, 98, 99, 104 o Some studies found more of an impact on emergency visits for chronic disease patients, compared to those without a chronic disease. 76, 104 o Fewer hospitalizations of asthma patients after implementation of PMH. 26, 28 o One study found a significant decrease in emergency service use for children with developmental disabilities. 51 o One study found a slight association between higher levels of medical homeness and lower avoidable ED use by children. 57 o Associated with a decrease in hospitalizations for U.S veterans with PTSD. 41 o Greater adoption of medical home features was negatively associated with risk of avoidable hospitalizations in several studies. 17, 42, 92, 94, 104 • No significant impact on emergency visits & hospitalizations o 20, 36(VHA. After 2 years). However, did significantly reduce sensitive ED visits., o 18 (after 1 year), 37 (VHA. After 2 years), 38 (After 3 years), 73, 77(Breast cancer), 111 • Increased emergency visits & hospitalizations o 112 () • Mixed results for emergency visits & hospitalizations o 115 • Reduced utilization o 7, 21, 99 • Increased primary care utilization o 52,(2 sites within a review article), 77(Breast cancer patients), 78(PTSD), 79, 83, 92, 101 (High-comorbidity patients), 109 (veterans), 112 (Medicare), 115 (large review) • Reduced care utilization o 7, 10, 52,69, 78 (PTSD), 92, 94, 109, 111 • Increased specialty care utilization o 77(Breast cancer patients), 112 (Medicare) • Cost savings o 3, 6, 7, 8, 9, 10, 11, 12, 13, 14, 30, 32, 33, 34, 46, 49, 52, 56, 59, 66, 84, 91, 93, 94, 98, 111, 115 o Higher functioning PMHs, or those operating for a longer period of time were associated with more cost savings. 8, 11, 94, 115

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o Savings were found to be more significant for patients with multiple chronic , or those who are generally higher risk. 32, 33, 49, 84, 111, 115 • No significant cost savings o 18 (1 year demonstration), 36(VHA), 38(3 years), 79(3 years), 99(3 years), 100 (2 years), 103 (pilot) • Improved preventive service delivery rates o 5, 15, 16, 18, 22, 30, 31, 39, 52, 58, 65, 71, 79, 80, 87, 88, 91, 111 o Several studies found a positive association between higher global PMH scores and receipt of preventive services. 5, 31, 58 o One study found that PMH implementation was associated with larger increases in screening in lower socioeconomic practice settings. 65. • No significant impact on preventive services o 20. (after 2 years. High NCQA implementation), 38 (After 3 years), 82 (Mental health patients) • Negative impact on preventive services o 81 (Breast cancer. 2 years) • Improved quality o 1, 3, 10, 22, 31, 42, 43, 47, 48, 58, 62, 71, 86, 95, 96, 97, 100, 110, 112 o Higher quality associated with full PMH implementation, compared to partial implementation. 31, 42, 58 o One study found improved quality of chronic disease care for diabetes, vascular disease, and asthma. 48 o Features consistent with higher medical-home performance are associated with improvements in diabetes care process measures. 47, 71, 95 • No significant/variable impact on quality o 92, 99, 103 (pilot), 105, 115 • Improved follow-up / care transitions in primary care o 85 • Improved access to care for patients o 6, 19, 22, 30, 50, 52, 74 • No significant impact on access o 108 • Fewer medical tests o 92 • Chronic disease patient clinical outcomes o One study found slightly better clinical outcomes in coronary heart disease patients. 14 o Another study found improved blood pressure control in hypertensive patients. 15 o Two studies found a positive association between PMH recognition and diabetes control. 29, 102

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o Among patients with multiple chronic conditions, adherence to is greater for those enrolled in medical homes. 64, 107 • Mental health patient clinical outcomes o One study found that greater increases in mental health recovery over time can be expected when patients with severe mental illness are provided treatment through the PMH. 54 o One study found that patients who have a usual provider with PMH qualities are more likely to receive mental health counseling. 70 • Pediatric populations o In US families of children with ADHD, care in a PMH was associated with 48% lower relative risk of financial problems and 36% lower relative risk of employment problems. 63 o In a trial of high-risk children with chronic illness, a medical home providing comprehensive care decreased rates of serious illness. 49 o Another study found an association between the medical home and perceived quality. 106 • Increased support for patient activation o One study found a strong association between PMH characteristics and clinic support for activation among minority patients in poor/fair health status. 45 • Improved patient satisfaction & experience o 1, 3, 10, 22, 23, 24, 25, 28, 30, 34, 52, 53, 72, 89, 106, 113 (slightly), 114, 115 o Some studies found that the PMH was associated with patient’s self-reported access to care. 25, 28 o One study found increased satisfaction coincided with full PMH implementation. 114 o One study found PMH improved child patient experience at pediatric practices and worsened experience at family practices. 89 • No impact on patient satisfaction & experience o 67 (VHA. 2 years) • Negative impact on patient satisfaction & experience o Positive impact at pediatric practice, negative impact at practice. 89 • Reduced burnout for staff o 1, 3, 42 • Increased staff satisfaction o 16, 19, 22, 52 • Decreased staff satisfaction o 55 • Mixed impact on satisfaction o 75

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Reference List

2009 1. Reid RJ, Fishman PA, Yu O, Ross TR, Tufano JT, Soman MP, et al. Patient-centered medical home demonstration: a prospective, quasi-experimental, before and after evaluation. Am J Manag Care. 2009 Sep;15(9):e71–87. http://www.ajmc.com/journals/issue/2009/2009-09-vol15- n9/ajmc_09sep_reidwebx_e71toe87

2. Cooley WC, McAllister JW, Sherrieb K, Kuhlthau K. Improved outcomes associated with medical home implementation in pediatric primary care. Pediatrics. 2009 Jul;124(1):358–64.

2010 3. Reid RJ, Coleman K, Johnson EA, Fishman PA, Hsu C, Soman MP, et al. The Group Health Medical Home At Year Two: Cost Savings, Higher Patient Satisfaction, And Less Burnout For Providers. Health Aff. 2010 May 1;29(5):835–43. http://content.healthaffairs.org/content/29/5/835.long

4. Gilfillan RJ, Tomcavage J, Rosenthal MB, Davis DE, Graham J, Roy JA, et al. Value and the medical home: effects of transformed primary care. Am J Manag Care. 2010 Aug;16(8):607– 14. http://www.ajmc.com/journals/issue/2010/2010-08-vol16- n08/AJMC_10augGilfillan607to614/

5. Ferrante JM, Balasubramanian BA, Hudson SV, Crabtree BF. Principles of the patient-centered medical home and preventive services delivery. Ann Fam Med. 2010 Apr;8(2):108–16. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2834717/

2011

6. Takach M. Reinventing : State Innovations To Qualify And Pay For Patient-Centered Medical Homes Show Promising Results. Health Aff. 2011 Jul 1;30(7):1325–34. http://content.healthaffairs.org/content/30/7/1325.long#abstract-1

7. Fontaine P, Flottemesch TJ, Solberg LI, Asche SE. Is consistent primary care within a patient- centered medical home related to utilization patterns and costs? J Ambul Care Manage. 2011 Mar;34(1):10–9.

8. Flottemesch TJ, Fontaine P, Asche SE, Solberg LI. Relationship of clinic medical home scores to costs. J Ambul Care Manage. 2011 Mar;34(1):78–89.

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2012 9. Rosenberg CN, Peele P, Keyser D, McAnallen S, Holder D. Results From A Patient-Centered Medical Home Pilot At UPMC Health Plan Hold Lessons For Broader Adoption Of The Model. Health Aff. 2012 Nov 1;31(11):2423–31.

10. Raskas RS, Latts LM, Hummel JR, Wenners D, Levine H, Nussbaum SR. Early Results Show WellPoint’s Patient-Centered Medical Home Pilots Have Met Some Goals For Costs, Utilization, And Quality. Health Aff. 2012 Sep 1;31(9):2002–9. http://content.healthaffairs.org/content/31/9/2002.full

11. Maeng DD, Graham J, Graf TR, Liberman JN, Dermes NB, Tomcavage J, et al. Reducing long- term cost by transforming primary care: evidence from Geisinger’s medical home model. Am J Manag Care. 2012 Mar;18(3):149–55. http://www.ajmc.com/journals/issue/2012/2012-3-vol18-n3/Reducing-Long-Term-Cost-by- Transforming-Primary-Care-Evidence-From-Geisingers-Medical-Home-Model/

12. Harbrecht MG, Latts LM. Colorado’s Patient-Centered Medical Home Pilot Met Numerous Obstacles, Yet Saw Results Such As Reduced Admissions. Health Aff. 2012 Sep 1;31(9):2010–7.

13. Arend J, Tsang-Quinn J, Levine C, Thomas D. The patient-centered medical home: history, components, and review of the evidence. Mt Sinai J Med. 2012 Aug;79(4):433–50.

2013 14. Liss DT, Fishman PA, Rutter CM, Grembowski D, Ross TR, Johnson EA, et al. Outcomes Among Chronically Ill Adults in a Medical Home Prototype. Am J Manag Care. 2013 Oct 1;19(10):e348–58. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4074014/

15. Fifield J, Forrest DD, Burleson JA, Martin-Peele M, Gillespie W. Quality and efficiency in small practices transitioning to patient centered medical homes: a randomized trial. J Gen Intern Med. 2013 Jun;28(6):778–86.

16. Jackson GL, Powers BJ, Chatterjee R, Prvu Bettger J, Kemper AR, Hasselblad V, et al. The Patient-Centered Medical Home: A Systematic Review. Annals of Internal Medicine. 2013 Feb 5;158(3):169. http://annals.org/article.aspx?articleID=1402441

17. Yoon J, Rose DE, Canelo I, Upadhyay AS, Schectman G, Stark R, et al. Medical Home Features of VHA Primary Care and Avoidable Hospitalizations. J Gen Intern Med. 2013 Sep;28(9):1188–94. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744290/

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18. Werner RM, Duggan M, Duey K, Zhu J, Stuart EA. The patient-centered medical home: an evaluation of a single private payer demonstration in New Jersey. Med Care. 2013 Jun;51(6):487–93.

19. Savage AI, Lauby T, Burkard JF. Examining selected patient outcomes and staff satisfaction in a primary care clinic at a military treatment facility after implementation of the patient- centered medical home. Mil Med. 2013 Feb;178(2):128–34. http://publications.amsus.org/doi/pdf/10.7205/MILMED-D-12-00188

20. 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 Nov 11;173(20):1907–13. http://archinte.jamanetwork.com/article.aspx?articleid=1735895

21. Reid RJ, Johnson EA, Hsu C, Ehrlich K, Coleman K, Trescott C, et al. Spreading a Medical Home Redesign: Effects on Use and Hospital Admissions. Ann Fam Med. 2013 May 1;11(Suppl 1):S19–26. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3707243/

22. Patient-Centered Primary Care Collaborative. Summary of patient-centered medical home cost and quality results, 2010 – 2013. PCPCC; 2013 Jul. https://www.pcpcc.org/resource/summary-patient-centered-medical-home-cost-and-quality- results-2010-%E2%80%93-2013

23. Maeng DD, Davis DE, Tomcavage J, Graf TR, Procopio KM. Improving patient experience by transforming primary care: evidence from Geisinger’s patient-centered medical homes. Popul Health Manag. 2013 Jun;16(3):157–63.

24. Lebrun-Harris LA, Shi L, Zhu J, Burke MT, Sripipatana A, Ngo-Metzger Q. Effects of Patient- Centered Medical Home Attributes on Patients’ Perceptions of Quality in Federally Supported Health Centers. Ann Fam Med. 2013 Nov;11(6):508–16. http://annfammed.org/content/11/6/508.full

25. Kern L, Dhopeshwarkar R, Edwards A, Kaushal R. Patient Experience Over Time in Patient- Centered Medical Homes. American Journal of Managed Care. 2013 May 17;19(5). http://www.ajmc.com/journals/issue/2013/2013-1-vol19-n5/patient-experience-over-time- in-patient-centered-medical-homes

26. Johnston JM, Smith JJ, Hiratsuka VY, Dillard DA, Szafran QN, Driscoll DL. Tribal implementation of a patient-centred medical home model in Alaska accompanied by decreased hospital use. Int J Circumpolar Health. 2013;72. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3753131/

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27. Hudak RP, Julian R, Kugler J, Dorrance K, Lynch S, Dinneen M, et al. The patient-centered medical home: a case study in transforming the military health system. Mil Med. 2013 Feb;178(2):146–52. http://publications.amsus.org/doi/pdf/10.7205/MILMED-D-12-00170

28. Driscoll DL, Hiratsuka V, Johnston JM, Norman S, Reilly KM, Shaw J, et al. Process and Outcomes of Patient-Centered Medical Care With Alaska Native People at Southcentral Foundation. Ann Fam Med. 2013 May 1;11(Suppl 1):S41–9. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3707246/

29. Calman NS, Hauser D, Weiss L, Waltermaurer E, Molina-Ortiz E, Chantarat T, et al. Becoming a patient-centered medical home: a 9-year transition for a network of Federally Qualified Health Centers. Ann Fam Med. 2013 Jun;11 Suppl 1:S68–73. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3707249/

2014 30. Nielsen M, Olayiwola JN, Grundy P, Grumbach K. The patient-centered medical home’s impact on cost and quality: an annual update of the evidence, 2012-2013. Patient-Centered Primary Care Collaborative (PCPCC); 2014 Jan. http://www.pcpcc.org/resource/medical-homes- impact-cost-quality

31. Paustian ML, Alexander JA, El Reda DK, Wise CG, Green LA, Fetters MD. Partial and incremental PMH practice transformation: implications for quality and costs. Health Serv Res. 2014 Feb;49(1):52–74.

32. Higgins S, Chawla R, Colombo C, Snyder R, Nigam S. Medical homes and cost and utilization among high-risk patients. Am J Manag Care. 2014 Mar;20(3):e61–71. http://www.ajmc.com/publications/issue/2014/2014-vol20-n3/Medical-Homes-and-Cost- and-Utilization-Among-High-Risk-Patients/

33. Fillmore H, DuBard CA, Ritter GA, Jackson CT. Health care savings with the patient-centered medical home: Community Care of North Carolina’s experience. Popul Health Manag. 2014 Jun;17(3):141–8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050704/

34. Carrillo JE, Carrillo VA, Guimento R, Mucaria J, Leiman J. The NewYork-Presbyterian Regional Health Collaborative: a three-year progress report. Health Aff (Millwood). 2014 Nov;33(11):1985–92.

35. Fandre M, McKenna C, Beauvais B, Kim F, Mangelsdorff AD. Patient-centered medical home implementation effects on emergency room utilization: a case study. Hosp Top. 2014 Sep;92(3):59–65.

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36. Hebert PL, Liu C-F, Wong ES, Hernandez SE, Batten A, Lo S, et al. Patient-Centered Medical Home Initiative Produced Modest Economic Results For Veterans Health Administration, 2010–12. Health Aff. 2014 Jun 1;33(6):980–7.

37. Werner RM, Canamucio A, Shea JA, True G. The medical home transformation in the Veterans Health Administration: an evaluation of early changes in primary care delivery. Health Serv Res. 2014 Aug;49(4):1329–47.

38. 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 Feb 26;311(8):815–25. http://jama.jamanetwork.com/article.aspx?articleid=1832540

39. Kern LM, Edwards A, Kaushal R. The Patient-Centered Medical Home, Electronic Health Records, and Quality of Care. Ann Intern Med. 2014 Jun 3;160(11):741–9.

40. David G, Gunnarsson C, Saynisch PA, Chawla R, Nigam S. Do Patient-Centered Medical Homes Reduce Emergency Department Visits? Health Serv Res. 2014 Aug 1.

41. Randall I, Mohr DC, Maynard C. VHA Patient-Centered Medical Home Associated With Lower Rate of Hospitalizations and Specialty Care Among Veterans With Posttraumatic Stress Disorder. J Healthc Qual. 2014 Nov 10;

42. Nelson KM, Helfrich C, Sun H, Hebert PL, Liu C-F, Dolan E, et al. Implementation of the patient-centered medical home in the Veterans Health Administration: associations with patient satisfaction, quality of care, staff burnout, and hospital and emergency department use. JAMA Intern Med. 2014 Aug;174(8):1350–8.

43. DePuccio MJ, Hoff TJ. Medical home interventions and quality outcomes for older adults: a systematic review. Qual Manag Health Care. 2014 Dec;23(4):226–39.

44. Smith JJ, Johnston JM, Hiratsuka VY, Dillard DA, Tierney S, Driscoll DL. Medical home implementation and trends in diabetes quality measures for AN/AI primary care patients. Prim Care Diabetes. 2014 Aug 2;

45. Nocon RS, Gao Y, Gunter KE, Jin J, Casalino LP, Quinn MT, et al. Associations Between Medical Home Characteristics and Support for Patient Activation in the Safety Net: Understanding Differences by Race, Ethnicity, and Health Status. Medical Care. 2014 Nov;52:S48–55.

46. Wang QC, Chawla R, Colombo CM, Snyder RL, Nigam S. Patient-centered medical home impact on health plan members with diabetes. J Public Health Manag Pract. 2014 Oct;20(5):E12–20.

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47. Stevens GD, Shi L, Vane C, Peters AL. Do experiences consistent with a medical-home model improve diabetes care measures reported by adult Medicaid patients? Diabetes Care. 2014 Sep;37(9):2565–71. http://care.diabetesjournals.org/content/37/9/2565.long

48. Sandberg SF, Erikson C, Owen R, Vickery KD, Shimotsu ST, Linzer M, et al. Hennepin Health: A Safety-Net Accountable Care Organization For The Expanded Medicaid Population. Health Aff. 2014 Nov 1;33(11):1975–84.

49. Mosquera RA, Avritscher EC, Samuels CL, et al. Effect of an enhanced medical home on serious illness and cost of care among high-risk children with chronic illness: A randomized clinical trial. JAMA. 2014 Dec 24;312(24):2640–8. http://jama.jamanetwork.com/article.aspx?articleid=2084891

50. Khanna N, Shaya F, Chirikov V, Steffen B, Sharp D. Dissemination and adoption of the advanced primary care model in the Maryland multi-payer patient centered medical home program. J Health Care Poor Underserved. 2014 Feb;25(1 Suppl):122–38.

51. Butcher JS, Wolraich ML, Gillaspy SR, Martin VG, Wild RC. The impact of a Medical Home for children with developmental disability within a pediatric resident continuity clinic. J Okla State Med Assoc. 2014 Dec;107(12):632–8.

2015 52. Nielson M, Gibson L, Buelt L, Grundy P, Grumbach K. The patient-centered medical home’s impact on cost and quality: Review of evidence 2013-2014. Patient-Centered Primary Care Collaborative (PCPCC); 2015. http://www.pcpcc.org/resource/patient-centered-medical-homes-impact-cost-and-quality

53.Xin H, Kilgore ML, Sen BP. Is Access to and Use of Primary Care Practices that Patients Perceive as Having Essential Qualities of a Patient-Centered Medical Home Associated With Positive Patient Experience? Empirical Evidence From a U.S. Nationally Representative Sample. J Healthc Qual. 2015 Apr

54.Sklar M, Aarons GA, O’Connell M, Davidson L, Groessl EJ. Mental Health Recovery in the Patient-Centered Medical Home. Am J Public Health. 2015 Jul 16;e1–9.

55.Richardson JE, Kern LM, Silver M, Jung H-Y, Kaushal R, with the HITEC Investigators. Satisfaction in Practices That Transformed Into Patient-Centered Medical Homes: A Statewide Study in New York. Am J Med Qual. 2015 Apr 15;

56.Maeng DD, Khan N, Tomcavage J, Graf TR, Davis DE, Steele GD. Reduced Acute Was Largest Savings Component Of Geisinger Health System’s Patient-Centered Medical Home. Health Aff. 2015 Apr 1;34(4):636–44.

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57.Christensen AL, Zickafoose JS, Natzke B, McMorrow S, Ireys HT. Associations Between Practice-Reported Medical Homeness and Health Care Utilization Among Publicly Insured Children. Academic Pediatrics. 2015 May 1;15(3):267–74.

58.Alexander JA, Markowitz AR, Paustian ML, Wise CG, El Reda DK, Green LA, et al. Implementation of Patient-Centered Medical Homes in Adult Primary Care Practices. Med Care Res Rev. 2015 Apr 10;

59.Neal Jason MA, Ravi Chawla MBA, Christine M. Colombo MBA, Richard L. Snyder MD, and Somesh Nigam P. Medical Homes: Cost Effects of Utilization by Chronically Ill Patients. American Journal of Managed Care. 2015 Feb 24; 21. http://www.ajmc.com/journals/issue/2015/2015-vol21-n1/Medical-Homes-Cost-Effects-of- Utilization-by-Chronically-Ill-Patients/

60.Yoon P, Chuan-Fen Liu P, Jeanie Lo MPH, Gordon Schectman MD, Richard Stark MD, Lisa V. Rubenstein MD, et al. Early Changes in VA Medical Home Components and Utilization. American Journal of Managed Care. 2015 Mar 20 ;21. http://www.ajmc.com/journals/issue/2015/2015-vol21-n3/early-changes-in-va-medical- home-components-and-utilization

61.Shi L, Lock DC, Lee D-C, Lebrun-Harris LA, Chin MH, Chidambaran P, et al. Patient-centered Medical Home Capability and Clinical Performance in HRSA-supported Health Centers. Med Care. 2015 Mar 12;

62.Moureaux C, Perelman J, Mendes da Costa E, Roch I, Annemans L, Heymans I, et al. Impact of the Medical Home Model on the Quality of Primary Care: The Belgian Experience. Med Care. 2015 Mar 24;

63.Ronis SD, Baldwin CD, Blumkin A, Kuhlthau K, Szilagyi PG. Patient-Centered Medical Home and Family Burden in Attention-Deficit Hyperactivity Disorder. J Dev Behav Pediatr. 2015 Aug;36(6):417–25.

64.Beadles CA, Farley JF, Ellis AR, Lichstein JC, Morrissey JP, DuBard CA, et al. Do medical homes increase adherence for persons with multiple chronic conditions? Med Care. 2015 Feb;53(2):168–76.

65.Markovitz AR, Alexander JA, Lantz PM, Paustian ML. Patient-Centered Medical Home Implementation and Use of Preventive Services: The Role of Practice Socioeconomic Context. JAMA Intern Med. 2015 Feb 16;

66.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 Feb;50(1):253–72.

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67.Reddy A, Canamucio A, Werner R. Impact of the Patient-Centered Medical Home on Veterans’ Experience of Care. American Journal of Managed Care. 2015 Jun 19;21(6). http://www.ajmc.com/journals/issue/2015/2015-vol21-n6/impact-of-patient-centered- medical-home-on-veterans-experience-care/P-1

68.Pines JM, Keyes V, van Hasselt M, McCall N. Emergency Department and Inpatient Hospital Use by Medicare Beneficiaries in Patient-Centered Medical Homes. Annals of Emergency Medicine. 2015 Jun 1;65(6):652–60.

69.Kaushal R, Edwards A, Kern LM. Association between the patient-centered medical home and healthcare utilization. Am J Manag Care. 2015 May;21(5):378–86. http://www.ajmc.com/journals/issue/2015/2015-vol21-n5/association-between-the-patient- centered-medical-home-and-healthcare-utilization

70.Jones AL, Cochran SD, Leibowitz A, Wells KB, Kominski G, Mays VM. Usual Primary Care Provider Characteristics of a Patient-Centered Medical Home and Mental Health Service Use. J Gen Intern Med. 2015 Jun 3;

71.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 Jun 1; http://dx.doi.org/10.1001/jamainternmed.2015.2047

72.Cook N, Hollar L, Isaac E, Paul L, Amofah A, Shi L. Patient Experience in Health Center Medical Homes. J Community Health. 2015 May 31;

73.Cole ES, Campbell C, Diana ML, Webber L, Culbertson R. Patient-Centered Medical Homes In Louisiana Had Minimal Impact On Medicaid Population’s Use Of And Costs. Health Aff. 2015 Jan 1;34(1):87–94.

74.Aysola J, Rhodes KV, Polsky D. Patient-centered Medical Homes and Access to Services for New Primary Care Patients. Med Care. 2015 Oct;53(10):857–62.

75.Commonwealth Fund, Henry J. Kaiser Family Foundation. Primary Care Providers’ Views of Recent Trends in Health Care Delivery and Payment. Findings from the Commonwealth Fund/Kaiser Family Foundation 2015 National Survey of Primary Care Providers. Issue Brief (Commonw Fund). 2015 Aug;24:1–13. http://www.commonwealthfund.org/publications/issue-briefs/2015/aug/primary-care- providers-views-delivery-payment

76.David G, Gunnarsson C, Saynisch PA, Chawla R, Nigam S. Do patient-centered medical homes reduce emergency department visits? Health Serv Res. 2015 Apr;50(2):418–39.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369216/

77.Kohler RE, Goyal RK, Lich KH, Domino ME, Wheeler SB. Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program. Cancer. 2015 Nov 15;121(22):3975–81. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004988/

78.Randall I, Mohr DC, Maynard C. VHA Patient-Centered Medical Home Associated With Lower Rate of Hospitalizations and Specialty Care Among Veterans With Posttraumatic Stress Disorder. J Healthc Qual. 2015 Nov 12;

79.Rosenthal MB, Sinaiko AD, Eastman D, Chapman B, Partridge G. Impact of the Rochester Medical Home Initiative on Primary Care Practices, Quality, Utilization, and Costs. Med Care. 2015 Nov;53(11):967–73.

80.VanGompel ECW, Jerant AF, Franks PM. Primary Care Attributes Associated with Receipt of Preventive Care Services: A National Study. J Am Board Fam Med. 2015 Dec;28(6):733–41. http://www.jabfm.org/content/28/6/733.long

2016 81.Baughman AW, Brawarsky P, Onega T, Tosteson TD, Wang Q, Tosteson ANA, et al. Medical home transformation and breast cancer screening. Am J Manag Care. 2016 Nov 1;22(11):e382–8. http://www.ajmc.com/journals/issue/2016/2016-vol22-n11/Medical-Home-Transformation- and-Breast-Cancer-Screening/

82.Bowdoin JJ, Rodriguez-Monguio R, Puleo E, Keller D, Roche J. Associations between the patient-centered medical home and preventive care and healthcare quality for non-elderly adults with mental illness: A surveillance study analysis. BMC Health Serv Res. 2016 Aug 24;16(1):434. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997759/

83.Chu L-H, Tu M, Lee Y-C, Sood N. The impact of patient-centered medical homes on safety net clinics. Am J Manag Care. 2016 Aug;22(87):532–8. http://www.ajmc.com/journals/issue/2016/2016-vol22-n8/the-impact-of-patient-centered- medical-homes-on-safety-net-clinics

84.Cuellar A, Helmchen LA, Gimm G, Want J, Burla S, Kells BJ, et al. The CareFirst Patient- Centered Medical Home Program: Cost and Utilization Effects in Its First Three Years. J Gen Intern Med. 2016 Nov;31(11):1382–8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5071295/

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85.Domino ME, Jackson C, Beadles CA, Lichstein JC, Ellis AR, Farley JF, et al. Do primary care medical homes facilitate care transitions after psychiatric discharge for patients with multiple chronic conditions? Gen Hosp . 2016 Apr;39:59–65. https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/26725539/

86.Elder N, Penm M, Pallerla H, Vonder Meulen MB, Short AD, Diers T, et al. Provision of Recommended Chronic and Management in Primary Care: Does Patient- Centered Medical Home (PCMH) Recognition Make a Difference? J Am Board Fam Med. 2016 Aug;29(4):474–81. http://www.jabfm.org/cgi/pmidlookup?view=long&pmid=27390379

87.Garcia-Huidobro D, Shippee N, Joseph-DiCaprio J, O’Brien JM, Svetaz MV. Effect of Patient- Centered Medical Home on Preventive Services for Adolescents and Young Adults. Pediatrics. 2016 Jun;137(6). http://pediatrics.aappublications.org/content/early/2016/05/12/peds.2015-3813

88.Green BB, Anderson ML, Chubak J, Baldwin LM, Tuzzio L, Catz S, et al. Colorectal Cancer Screening Rates Increased after Exposure to the Patient-Centered Medical Home (PCMH). J Am Board Fam Med. 2016 Apr;29(2):191–200. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868497/

89.Harder VS, Krulewitz J, Jones C, Wasserman RC, Shaw JS. Effects of Patient-centered Medical Home Transformation on Child Patient Experience. J Am Board Fam Med. 2016 Feb;29(1):60– 8. http://www.jabfm.org/content/29/1/60.full

90.Hearld LR, Hearld KR, Guerrazzi C. Patient-Centered Medical Home Capacity and Ambulatory Care Utilization. Am J Med Qual. 2016 Nov 15;

91.Jones C, Finison K, McGraves-Lloyd K, Tremblay T, Mohlman MK, Tanzman B, et al. Vermont’s Community-Oriented All-Payer Medical Home Model Reduces Expenditures and Utilization While Delivering High-Quality Care. Popul Health Manag. 2016;19(3):196–205. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913508/

92.Kern LM, Edwards A, Kaushal R. The patient-centered medical home and associations with and utilization: A 5-Year cohort study. Ann Intern Med. 2016 Mar 15;164(6):395–405.

93.Maeng DD, Sciandra JP, Tomcavage JF. The impact of a regional patient-centered medical home initiative on cost of care among commercially insured population in the US. Risk Manag Healthc Policy. 2016;9:67–74. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888859/

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94.Nielsen M, Buelt L, Patel K, Nichols L. The Patient-Centered Medical Home’s impact on cost and quality: annual review of evidence, 2014-2015. Patient-Centered Primary Care Collaborative (PCPCC); 2016 Feb. https://www.pcpcc.org/resource/patient-centered-medical-homes- impact-cost-and-quality-2014-2015

95.An J. The Impact of Patient-Centered Medical Homes on Quality of Care and Medication Adherence in Patients with Diabetes Mellitus. J Manag Care Spec Pharm. 2016 Nov;22(11):1272–84. http://www.jmcp.org/doi/full/10.18553/jmcp.2016.22.11.1272

96.Pourat N, Charles SA, Snyder S. Availability of Care Concordant With Patient-centered Medical Home Principles Among Those With Chronic Conditions: Measuring Care Outcomes. Med Care. 2016 Mar;54(3):262–8.

97.Reibling N. The Patient-Centered Medical Home: How Is It Related to Quality and Equity Among the General Adult Population? Med Care Res Rev. 2016 Oct;73(5):606–23.

98.Rhodes KV, Basseyn S, Gallop R, Noll E, Rothbard A, Crits-Christoph P. Pennsylvania’s Medical Home Initiative: Reductions in Healthcare Utilization and Cost Among Medicaid Patients with Medical and Psychiatric Comorbidities. J Gen Intern Med. 2016 Nov;31(11):1373–81.

99.Rosenthal MB, Alidina S, Friedberg MW, Singer SJ, Eastman D, Li Z, et al. A Difference-in- Difference Analysis of Changes in Quality, Utilization and Cost Following the Colorado Multi- Payer Patient-Centered Medical Home Pilot. J Gen Intern Med. 2016 Mar;31(3):289–96. https://link.springer.com/article/10.1007/s11606-015-3521-1#enumeration

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2017

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103.Flieger SP. Impact of a Patient-Centered Medical Home Pilot on Utilization, Quality, and Costs and Variation in Medical Homeness. J Ambul Care Manage. 2017 Sep;40(3):228–37.

104.Green LA, Chang H-C, Markovitz AR, Paustian ML. The Reduction in ED and Hospital Admissions in Medical Home Practices Is Specific to Primary Care-Sensitive Chronic Conditions. Health Serv Res. 2017 Mar 2;

105.Gunter KE, Nocon RS, Gao Y, Casalino LP, Chin MH. Medical Home Characteristics and Quality of Diabetes Care in Safety Net Clinics. J Community Health. 2017 Apr;42(2):303–11.

106.Han B, Yu H, Friedberg MW. Evaluating the Impact of Parent-Reported Medical Home Status on Children’s Health Care Utilization, Expenditures, and Quality: A Difference-in-Differences Analysis with Causal Inference Methods. Health Serv Res. 2017 Apr;52(2):786–806.

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108.Leroux TC, Côté MJ, Kum H-C, Dabney A, Wells R. Transitioning to Patient-Centered Medical Homes: Associations With Appointment Availability. Mil Med. 2017 Mar;182(3):e1741–6.

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112.Timbie JW, Hussey PS, Setodji CM, Kress A, Malsberger R, Lavelle TA, et al. Association Between Patient-Centered Medical Home Capabilities and Outcomes for Medicare Beneficiaries Seeking Care from Federally Qualified Health Centers. J Gen Intern Med. 2017 May 26;

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114.Xin H, Kilgore ML, Sen BP. Is Access to and Use of Primary Care Practices that Patients Perceive as Having Essential Qualities of a Patient-Centered Medical Home Associated With Positive Patient Experience? Empirical Evidence From a U.S. Nationally Representative Sample. J Healthc Qual. 2017 Feb;39(1):4–14.

115.Jabbarpour Y, DeMarchis E, Bazemore A, Grundy P. The impact of primary care practice transformation on cost, quality, and utilization: A systematic review of research published in 2016. Patient-Centered Primary Care Collaborative (PCPCC); 2017. Available from: https://www.pcpcc.org/resource/impact-primary-care-practice-transformation-cost-quality- and-utilization

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