Premium
The impact of patient‐centered medical homes on medication adherence?
Author(s) -
David Guy,
Saynisch Philip,
Luster Spencer,
SmithMcLallen Aaron,
Chawla Ravi
Publication year - 2018
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.3804
Subject(s) - medical home , accreditation , flexibility (engineering) , medicine , medication adherence , health care , primary care , family medicine , medical education , statistics , mathematics , economics , economic growth
Accreditation of providers helps resolve the pervasive information asymmetries in health care markets. However, meeting accreditation standards typically involves flexibility in implementation, leading to heterogeneity in performance. For example, the patient‐centered medical home (PCMH) is a leading model for recognizing high‐performing primary care practices. Flexibility in PCMH implementation allows for varying degrees of emphasis on processes designed to enhance medication adherence. To assess the impact of the PCMH on adherence, we combine 6 years of detailed patient claims data with a novel dataset containing detailed practice‐level PCMH attributes. We study the effects of the number and configuration of adherence‐relevant capabilities, using variation in the timing of PCMH adoption to estimate its impact. While PCMH adoption improved overall medication adherence, when combining claims data with the unique recognition data detailing what PCMH capabilities were adopted, we find that these gains are concentrated among patients in practices that adopted more adherence‐relevant capabilities. Despite mixed evidence in the literature concerning costs and utilization, our results indicate that PCMH recognition improves medication adherence.