Report: Medical Home Demonstration Fails To Meet Goals, Savings
A $57 million HHS demonstration project aimed at bolstering care quality and efficiency at federally funded health centers did not meet its targets and is not likely to generate savings, according to a report commissioned by CMS, Kaiser Health News reports.
The project provided community health centers with extra funding to become "medical homes," which coordinate care across providers, including:
- Emergency departments;
- Hospitals; and
The report, which was conducted by RAND, found 69% of the clinics that had not dropped out of the demonstration project received full accreditation as medical homes. However, HHS had set a goal of having 90% of the organizations reach accreditation.
In addition, HHS had hoped the program would reduce the number of patients' unnecessary hospital visits. However, emergency department visits and hospital admissions both increased in participating facilities when compared with facilities not in the program.
According to the report, costs also increased in participating facilities when compared with non-participants. The report concluded, "It appears that the demonstration will not achieve cost savings."
Analysts said the program might have helped clinics to find patients with pent-up medical needs, which could have caused the increase in utilization and costs.
Katherine Kahn, who headed RAND's evaluation of the program, said the clinics "were developed to care for more indigent people," so it is "not even entirely clear that one should expect lower costs initially."
According to KHN, HHS had been considering whether to expand the program past its three-year demonstration period. However, the Affordable Care Act, which funded the program, calls for HHS to cease demonstrations that do not improve care or cut down costs.
Some Say Medical Homes Still Worthwhile
Still, some health reform experts warned against using the report as evidence medical homes will not work as intended. According to KHN, the demonstration was only lightly tested.
Amy Simmons Farber, spokesperson for the National Association of Community Health Centers, said, "No one study should define the value" of medical homes.
Meanwhile, others said the program did not provide enough funding for the number of centers HHS included in the demonstration. According to KHN, some experts say the key to advancing medical homes is providing adequate financial incentives for physicians to adjust referral patterns (Hancock, Kaiser Health News, 7/27).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.