Excerpt from the Executive Summary
As in previous editions, this year’s Annual Review of the Evidence provides a summary of PCMH cost and utilization results from peer-reviewed studies, state government evaluations, industry reports, and new this year, independent federal program evaluations published between October 2014 and November 2015. It reviews the recent evidence for PCMH and advanced primary care in light of new and long-awaited developments in health system payment reform including Medicare’s transition to value-based payments and passage of the Medicare Access and CHIP Reauthorization Act (MACRA). In addition, significant multi-payer and state-level reforms are happening across the United States in conjunction with increasing commercial interest and investment in advanced primary care.
Key points from this year’s evidence review include:
- Controlling Costs by Right Sizing Care: Advanced primary care is foundational to delivery system transformation — medical home initiatives continue to reduce health care costs and unnecessary utilization of services
- Aligning Payment and Performance: Payment reform is necessary to sustain delivery system changes, but alignment across payers is critical for health care provider buy-in
- Assessing and Promoting Value: Measurement for PCMHs must be aligned and focused on value for patients, providers, and payers