TY - JOUR
KW - Community Health Workers
KW - Cost Savings
KW - Humans
KW - Patient-Centered Care/economics
KW - patient-centered medical homes
AU - M. L. Moffett
AU - A. Kaufman
AU - A. Bazemore
A1 - 
AB - The Patient-Centered Medical Home (PCMH) model demonstrated that processes of care can be improved while unnecessary care, such as preventable emergency department utilization, can be reduced through better care coordination. A complementary model, the Integrated Primary Care and Community Support (I-PaCS) model, which integrates community health workers (CHWs) into primary care settings, functions beyond improved coordination of primary medical care to include management of the social determinants of health. However, the PCMH model puts downward pressure on the panel sizes of primary care providers, increasing the average fixed costs of care at the practice level. While the I-PaCS model layers an additional cost of the CHWs into the primary care cost structure, that additional costs is relatively small. The purpose of this study is to simulate the effects of the PCMH and I-PaCS models over a 3-year period to account for program initiation to maturity. The costs and cost offsets of the model were estimated at the clinic practice level. The studies which find the largest cost savings are for high-risk, paneled patients and therefore do not represent the effects of the PCMH model on moderate-utilizing patients or practice-level effects. We modeled a 12.6% decrease in the inpatient hospital, outpatient hospital and emergency department costs of high and moderate risk patients. The PCMH is expected to realize a 1.7% annual savings by year three while the I-PaCS program is expected to a 7.1% savings in the third year. The two models are complementary, the I-PaCS program enhancing the cost reduction capability of the PCMH.
AD - Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA.; Office for Community Health, University of New Mexico, 2400 Tucker, NE, Albuquerque, NM, 87131, USA. akaufman@salud.unm.edu.; The Robert Graham Center, Washington, DC, USA.
BT - Journal of community health
C5 - Financing & Sustainability; Medical Home
CP - 1
CY - Netherlands
DO - 10.1007/s10900-017-0403-y
IS - 1
JF - Journal of community health
M1 - Journal Article
N2 - The Patient-Centered Medical Home (PCMH) model demonstrated that processes of care can be improved while unnecessary care, such as preventable emergency department utilization, can be reduced through better care coordination. A complementary model, the Integrated Primary Care and Community Support (I-PaCS) model, which integrates community health workers (CHWs) into primary care settings, functions beyond improved coordination of primary medical care to include management of the social determinants of health. However, the PCMH model puts downward pressure on the panel sizes of primary care providers, increasing the average fixed costs of care at the practice level. While the I-PaCS model layers an additional cost of the CHWs into the primary care cost structure, that additional costs is relatively small. The purpose of this study is to simulate the effects of the PCMH and I-PaCS models over a 3-year period to account for program initiation to maturity. The costs and cost offsets of the model were estimated at the clinic practice level. The studies which find the largest cost savings are for high-risk, paneled patients and therefore do not represent the effects of the PCMH model on moderate-utilizing patients or practice-level effects. We modeled a 12.6% decrease in the inpatient hospital, outpatient hospital and emergency department costs of high and moderate risk patients. The PCMH is expected to realize a 1.7% annual savings by year three while the I-PaCS program is expected to a 7.1% savings in the third year. The two models are complementary, the I-PaCS program enhancing the cost reduction capability of the PCMH.
PP - Netherlands
PY - 2018
SN - 1573-3610; 0094-5145
SP - 1
EP - 3
EP - 
T1 - Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
T2 - Journal of community health
TI - Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
U1 - Financing & Sustainability; Medical Home
U2 - 28695425
U3 - 10.1007/s10900-017-0403-y
VL - 43
VO - 1573-3610; 0094-5145
Y1 - 2018
Y2 - Feb
ER -