ArticleAnnals of family medicine2016
Effects of New Funding Models for Patient-Centered Medical Homes on Primary Care Practice Finances and Services: Results of a Microsimulation Model.
Article in Annals of family medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Payment methods for healthcare providers working in outpatient healthcare settings.The Cochrane database of systematic reviews · 2021Pooled it
- Coordinated care program in the Polish primary healthcare: insights into the early implementation.Archives of public health = Archives belges de sante publique · 2025Article
- Association of Time-Based Billing With Evaluation and Management Revenue for Outpatient Visits.JAMA network open · 2022Article
- Geographic proximity to primary care providers as a risk-assessment criterion for quality performance measures.PloS one · 2022Article
- Understanding Patient Perceptions Towards Direct Primary Care: A Focus Group Study.Journal of patient experience · 2022Article
- Association of Patient-Centered Medical Home designation and quality indicators within HRSA-funded community health center delivery sites.BMC health services research · 2020Article
- Shifting Implementation Science Theory to Empower Primary Care Practices.Annals of family medicine · 2019Article
- Finding a Parsimonious Path for Primary Care Practice Transformation.Annals of family medicine · 2018Article
- Synthesis Of Research On Patient-Centered Medical Homes Brings Systematic Differences Into Relief.Health affairs (Project Hope) · 2017Article
- Time to Do the Right Thing: End Fee-for-Service for Primary Care.Annals of family medicine · 2016Article
- Estimating the Costs of Implementing Comprehensive Primary Care: A Narrative Review.Health services research and managerial epidemiologyReview
- Contextual factors that influence quality improvement implementation in primary care: The role of organizations, teams, and individuals.Health care management reviewArticle
- Offsetting Patient-Centered Medical Homes Investment Costs Through Per-Member-Per-Month or Medicare Merit-based Incentive Payment System Incentive Payments.The Journal of ambulatory care managementArticle
- Costs of Transforming Established Primary Care Practices to Patient-Centered Medical Homes (PCMHs).Journal of the American Board of Family Medicine : JABFMArticle
- Visit Entropy Associated with Diabetic Control Outcomes.Journal of the American Board of Family Medicine : JABFMArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe assess the financial implications for primary care practices of participating in patient-centered medical home (PCMH) funding initiatives.
methodsWe estimated practices' changes in net revenue under 3 PCMH funding initiatives: increased fee-for-service (FFS) payments, traditional FFS with additional per-member-per-month (PMPM) payments, or traditional FFS with PMPM and pay-for-performance (P4P) payments. Net revenue estimates were based on a validated microsimulation model utilizing national practice surveys. Simulated practices reflecting the national range of practice size, location, and patient population were examined under several potential changes in clinical services: investments in patient tracking, communications, and quality improvement; increased support staff; altered visit templates to accommodate longer visits, telephone visits or electronic visits; and extended service delivery hours.
resultsUnder the status quo of traditional FFS payments, clinics operate near their maximum estimated possible net revenue levels, suggesting they respond strongly to existing financial incentives. Practices gained substantial additional net annual revenue per full-time physician under PMPM or PMPM plus P4P payments ($113,300 per year, 95% CI, $28,500 to $198,200) but not under increased FFS payments (-$53,500, 95% CI, -$69,700 to -$37,200), after accounting for costs of meeting PCMH funding requirements. Expanding services beyond minimum required levels decreased net revenue, because traditional FFS revenues decreased.
conclusionsPCMH funding through PMPM payments could substantially improve practice finances but will not offer sufficient financial incentives to expand services beyond minimum requirements for PCMH funding.
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