Medical Home Initiatives Are Rapidly Expanding

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Two Commonwealth Fund–supported studies in the new issue of <em>Health Affairs </em>examine national survey data on medical home initiatives and accountable care organizations.<br /><br />
<a href="/publications/journal-article/2014/oct/patient-centered-medical-home-initiatives-expanded-2009-13">Patient-Centered Medical Home Initiatives Expanded in 2009–13: Providers, Patients, and Payment Incentives Increased</a>, by Samuel Edwards, Asaf Bitton, Johan Hong, and Bruce E. Landon.<strong> </strong>In comparing survey findings for 2009 and 2013, the researchers found a fourfold increase in both the number of patient-centered medical home initiatives and the number of patients enrolled in them. Current initiatives are larger and tend to lack end dates; they also offer higher fees to providers. <br />
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The researchers say the findings point to growing recognition of the importance of investing in primary care and the substantial effort required to change practice patterns and provider behavior.<br />
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<a href="/publications/journal-article/2014/oct/few-acos-pursue-innovative-models-integrate-care-mental">Few ACOs Pursue Innovative Models That Integrate Care for Mental Illness and Substance Abuse with Primary Care</a>, by Valerie A. Lewis, Carrie H. Colla, Katherine Tierney, Arica D. Van Citters, Elliott S. Fisher, and Ellen Meara. Integrating primary care and behavioral health services can improve patients’ physical and mental health outcomes and help control costs. But while accountable care organizations, or ACOs, have built-in incentives to integrate these services, few have approached complete integration, and more than one-third have no formal relationships with behavioral health care providers.<br />
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According to the authors, factors that appear to drive integration include pay-for-performance contracts that use behavioral health quality measures, such as depression screening rates, and the inclusion of behavioral health costs in the ACO contract.<br />
<br /> Read the studies