Medical-home recognition higher in demonstration sites

(HealthDay)—Demonstration sites, which are provided with care management fees and technical assistance to help them achieve the highest medical-home recognition, do have higher rates of medical-home recognition, according to a study published online June 21 in the New England Journal of Medicine.

Justin W. Timbie, Ph.D., from RAND in Arlington, Va., and colleagues examined the achievement of medical-home recognition and measured utilization of services, quality of care, patients' experiences, and Medicare expenditures in demonstration versus comparison sites.

The researchers found that 70 percent of demonstration sites and 11 percent of comparison sites were awarded level 3 medical-home recognition. In both groups, the number of visits to federally-qualified health centers decreased; smaller reductions were seen among demonstration sites, leading to a relative increase of 83 visits per 1,000 beneficiaries per year at demonstration sites (P < 0.001). With respect to annual eye examinations and nephropathy tests, similar trends explained the higher performance of demonstration sites (both P < 0.001); no significant differences were seen for three other process measures. Relative to comparison sites, demonstration sites had larger increases in emergency department visits (P < 0.001), inpatient admissions (P = 0.02), and Medicare Part B expenditures (P = 0.02).

"Demonstration sites had higher rates of medical-home recognition and smaller decreases in the number of patients' visits to federally-qualified health centers than did comparison sites," the authors write.