ArticleJournal of general internal medicine2016
Pennsylvania's Medical Home Initiative: Reductions in Healthcare Utilization and Cost Among Medicaid Patients with Medicaland Psychiatric Comorbidities.
Article in Journal of general internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Impact of team-based primary care on health care utilization among patients with mental and substance use disorders: a systematic review of English-language articles.Family practice · 2025Pooled it
- Health Care Models for Persons with Multiple Chronic Conditions from Populations that Experience Health Disparities: A Scoping Review.Journal of general internal medicine · 2025Article
- Care Management Processes Important for High-Quality Diabetes Care.Diabetes care · 2023Article
- Stakeholder Perspectives on Access to IBD Care: Proceedings From a National IBD Access Summit.Journal of the Canadian Association of Gastroenterology · 2022Article
- The impact of opioid prescribing report cards in Medicaid.Journal of managed care & specialty pharmacy · 2022Article
- The impact of patient-centered medical home certification on quality of care for patients with diabetes.Health services research · 2021Article
- Are There Performance Advantages Favoring Federally Qualified Health Centers in Medical Home Care for Persons with Severe Mental Illness?Administration and policy in mental health · 2021Article
- Association of Patient-Centered Medical Home designation and quality indicators within HRSA-funded community health center delivery sites.BMC health services research · 2020Article
- Advancing mental health equality: a mapping review of interventions, economic evaluations and barriers and facilitators.Systematic reviews · 2020Review
- The medical home functions of primary care practices that care for adults with psychological distress: a cross-sectional study.BMC health services research · 2019Article
- Impact of a medical home model on costs and utilization among comorbid HIV-positive Medicaid patients.The American journal of managed care · 2018Article
- Continuity of Medication Management among Adults with Schizophrenia and Comorbid Cardiometabolic Conditions.Journal of pharmaceutical health services research : an official journal of the Royal Pharmaceutical Society of Great Britain · 2018Article
- Cultural Influences on Primary Care Delivery.Journal of general internal medicine · 2016Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Chronic Care Initiative (CCI) was a large state-wide patient-centered medical home (PCMH) initiative in Pennsylvania in place from 2008-2011.
objectiveDetermine whether the CCI impacted the utilization and costs for Medicaid patients with chronic medical conditions and comorbid psychiatric or substance use disorders.
designAnalysis of Medicaid claims using difference-in-difference regression analyses to compare changes in utilization and costs for patients treated at CCI practices to propensity score-matched patients treated at comparison non-CCI practices.
settingNinety-six CCI practices in Pennsylvania and 60 non-CCI practices during the same time period.
participantsA total of 11,105 comorbid Medicaid patients treated in CCI practices and an equal number of propensity-matched comparison patients treated in non-CCI practices. MEASUREMENTS: Changes in total per-patient costs from 1 year prior to 1 year following an index episode period. Secondary outcomes included utilization and costs for emergency department (ED), inpatient, and outpatient services.
resultsThe CCI group experienced an average adjusted total cost savings of $4145.28 per patient per year (P = 0.023) for the CCI relative to the non-CCI group. This was largely driven by a $3521.15 savings (P = 0.046) in inpatient medical costs, in addition to relative savings in outpatient psychiatric ($21.54, P < 0.001) and substance abuse service costs ($16.42, P = 0.013), compared to the non-CCI group. The CCI group, related to the non-CCI group, had decreases in expected mean counts of ED visits (for those who had any) and psychiatric hospitalizations of 15.6 (95 % CI: -21, -9) and 40.7 (95 % CI: -57, -18) percentage points respectively. LIMITATIONS: We do not measure quality of care and cannot make conclusions about the overall cost-effectiveness or long-term effects of the CCI.
conclusionsThe CCI was associated with substantial cost savings, attributable primarily to reduced inpatient costs, among a high-risk group of Medicaid patients, who may disproportionally benefit from care management in patient-centered medical homes.
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