Patient-Centered Medical Home Features and Health Care Expenditures of Medicare Beneficiaries with Chronic Disease Dyads

Lindsey M. Philpot, Erica L. Stockbridge, Norma A. Padrón, Jose Pagan

Research output: Contribution to journalArticle

Abstract

Three out of 4 Medicare beneficiaries have multiple chronic conditions, and managing the care of this growing population can be complex and costly because of care coordination challenges. This study assesses how different elements of the patient-centered medical home (PCMH) model may impact the health care expenditures of Medicare beneficiaries with the most prevalent chronic disease dyads (ie, co-occurring high cholesterol and high blood pressure, high cholesterol and heart disease, high cholesterol and diabetes, high cholesterol and arthritis, heart disease and high blood pressure). Data from the 2007-2011 Medical Expenditure Panel Survey suggest that increased access to PCMH features may differentially impact the distribution of health care expenditures across health care service categories depending on the combination of chronic conditions experienced by each beneficiary. For example, having no difficulty contacting a provider after regular hours was associated with significantly lower outpatient expenditures for beneficiaries with high cholesterol and diabetes (n = 635; P = 0.038), but it was associated with significantly higher inpatient expenditures for beneficiaries with high blood pressure and high cholesterol (n = 1599; P = 0.015), and no significant differences in expenditures in any category for beneficiaries with high blood pressure and heart disease (n = 1018; P > 0.05 for all categories). However, average total health care expenditures are largely unaffected by implementing the PCMH features considered. Understanding how the needs of Medicare beneficiaries with multiple chronic conditions can be met through the adoption of the PCMH model is important not only to be able to provide high-quality care but also to control costs. (Population Health Management 2016;19:206-211)

Original languageEnglish (US)
Pages (from-to)206-211
Number of pages6
JournalPopulation Health Management
Volume19
Issue number3
DOIs
StatePublished - Jun 1 2016

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Patient-Centered Care
Home Care Services
Health Expenditures
Medicare
Chronic Disease
Delivery of Health Care
Cholesterol
Hypertension
Heart Diseases
Cost Control
Hematologic Diseases
Quality of Health Care
Population
Health Services
Arthritis
Inpatients
Outpatients
Health

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Public Health, Environmental and Occupational Health

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Patient-Centered Medical Home Features and Health Care Expenditures of Medicare Beneficiaries with Chronic Disease Dyads. / Philpot, Lindsey M.; Stockbridge, Erica L.; Padrón, Norma A.; Pagan, Jose.

In: Population Health Management, Vol. 19, No. 3, 01.06.2016, p. 206-211.

Research output: Contribution to journalArticle

Philpot, Lindsey M. ; Stockbridge, Erica L. ; Padrón, Norma A. ; Pagan, Jose. / Patient-Centered Medical Home Features and Health Care Expenditures of Medicare Beneficiaries with Chronic Disease Dyads. In: Population Health Management. 2016 ; Vol. 19, No. 3. pp. 206-211.
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