Study: Most Medicaid beneficiaries receive care consistent with patient-centered medical home model

The majority of Medicaid beneficiaries feel that the medical care they receive is patient-centered, accessible and well-coordinated between primary care providers and specialists, according to a Virginia Commonwealth University-led study.

In an article that was published this month in the journal Health Affairs, Peter Cunningham, Ph.D., professor in the Department of Healthcare Policy and Research at the VCU School of Medicine, examined the prevalence of five aspects of the patient-centered medical home model among the Medicaid population from the perspective of Medicaid patients. Most Medicaid beneficiaries with no other coverage and a continuing source of primary care described the care they receive as consistent with at least three of five key attributes of the patient-centered medical home model.

“Patient-centered medical homes are a way of delivering primary care that stresses the patient experience,” Cunningham said. “The patient-centered medical home model is one of the primary delivery system innovations in the health care system to try to improve quality of care and lower costs.”

Using nationally representative data from the U.S. Department of Health and Human Services’ Medical Expenditure Panel Survey, Cunningham focused on five key patient-centered medical home attributes — serving multiple health needs, accessibility of phone contact, extended office hours, coordination of prescriptions, and shared decision-making — to get an understanding of the number of Medicaid patients nationally who are in primary care practices that have some attributes of patient-centered medical homes.

He found that younger, healthier and higher-income Medicaid beneficiaries tended to report care sources with multiple attributes, compared to the older, sicker and lower-income beneficiaries, who may be more likely to benefit from access to such care.

“Those who have a primary care provider with a lot of patient-centered medical home characteristics tend to be young and healthy rather than older and sick,” Cunningham said. “However, the benefits of a patient-centered medical home will accrue more for patients who are older and sicker and have more complex health needs because they are the ones generating most of the costs and concerns regarding quality of care.”

As of January 2015, 46 states including Virginia and the District of Columbia had implemented some type of patient-centered medical home program for Medicaid and the Children’s Health Insurance Program.