Substantial Costs to Sustain Patient-Centered Medical Homes

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Substantial Costs to Sustain Patient-Centered Medical Homes
Substantial Costs to Sustain Patient-Centered Medical Homes

WEDNESDAY, Sept. 16, 2015 (HealthDay News) -- Costs of sustaining patient-centered medical homes (PCMHs) have been detailed in new research published in the September/October issue of the Annals of Family Medicine.

Michael K. Magill, M.D., of the University of Utah in Salt Lake City, and colleagues developed a PCMH cost dimensions tool to assess the costs associated with PCMH functions. Direct personnel costs associated with staffing required to deliver PCMH functions were examined for 20 varied primary care practices in two states, Utah and Colorado.

The researchers found that the costs per full-time-equivalent primary care clinician associated with delivering PCMH functions varied by practice, averaging $7,691 per month in Utah and $9,658 in Colorado. Incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. For an assumed panel of 2,000 patients, the average estimated cost per member per month was $3.85 in Utah and $4.83 in Colorado.

"In conclusion, there are substantial costs associated with the delivery of PCMH functions," the authors write. "We found that the costs of delivering these functions, most of which are not reimbursable in a FFS environment, are approximately $105,000 per FTE clinician annually. Payment reform to offset the marginal costs of PCMH is essential for primary care practices to sustain medical home services."

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