Economic benefits of implementing patient-centered medical home among patients with hypertension

Abstract

Introduction: Despite the strong evidence of an association between adoption of the patient-centered medical home (PCMH) and improved clinical outcomes among patients with hypertension, evidence for associations between the PCMH and health care utilization and cost reduction within the general adult population with hypertension is less developed.

Objective: This study was designed to examine the effect of PCMH on health service expenditures and utilization in a national sample of the US adult population who were diagnosed with hypertension.

Methods: The 2010-2015 Medical Expenditure Panel Survey data were used. The study sample was limited to adults (≥18 years) diagnosed with essential hypertension. We investigated the impact of PCMH on the direct hypertension-related total and on the costs of inpatient stays, prescription medications, outpatient visits, emergency room visits, office-based services, and other medical expenditures by using log-transformed multiple linear regression models and the propensity score method.

Results: Of the 18,630 adults identified with hypertension, 19.2% (n=3,583) of them had received PCMH care from 2010 to 2015. After matching, the no PCMH group showed greater mean in all hypertension-related health service costs and utilization. After adjusting for the remaining con-founders, the PCMH group showed a significant association with lower total costs, office-based services, number of office-based visits, and outpatient visits compared with the control group.

Conclusion: A significant relationship between experiencing PCMH care and a lower total health care expenditure was found in patients with hypertension.

Keywords: MEPS; PCMH; health care expenditure; hypertension.