The Patient-Centered Medical Home (PCMH) is a widely-implemented model for improving primary care, emphasizing care coordination, information technology, and process improvements. However, its treatment as an undifferentiated intervention in policy evaluation obscures meaningful variation in implementation. This heterogeneity leads to contracting inefficiencies between insurers and practices and may account for mixed evidence on its success. Using a novel dataset we group practices into meaningful implementation clusters and then link these clusters with detailed patient claims data. We find implementation choice affects performance, suggesting that generally-unobserved features of primary care reorganization influence patient outcomes. Reporting these features may be valuable to insurers and their members.
{"title":"The Economics of Patient-Centered Care","authors":"G. David, Phil Saynisch, A. Smith-McLallen","doi":"10.2139/ssrn.3043025","DOIUrl":"https://doi.org/10.2139/ssrn.3043025","url":null,"abstract":"The Patient-Centered Medical Home (PCMH) is a widely-implemented model for improving primary care, emphasizing care coordination, information technology, and process improvements. However, its treatment as an undifferentiated intervention in policy evaluation obscures meaningful variation in implementation. This heterogeneity leads to contracting inefficiencies between insurers and practices and may account for mixed evidence on its success. Using a novel dataset we group practices into meaningful implementation clusters and then link these clusters with detailed patient claims data. We find implementation choice affects performance, suggesting that generally-unobserved features of primary care reorganization influence patient outcomes. Reporting these features may be valuable to insurers and their members.","PeriodicalId":375769,"journal":{"name":"Wharton School: Health Care Management (Topic)","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133035773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This Policy Brief provides an overview of the 2010 Affordable Care Act and perspective on some of its key provisions affecting health insurance. Following a synopsis of the main problems that confront U.S. health care and insurance, it considers the extent to which the Affordable Care Act (ACA) will affect those problems, including the ACA’s minimum medical loss ratio and rate review requirements for health insurers. It discusses the economics of the individual mandate, implications of possible court rulings on the mandate’s constitutionality, and implementation of the ACA to date. It concludes with brief description of market-oriented alternatives to the ACA that will likely be considered if the Republicans win the 2012 presidential election, retain the House, and capture a sufficient majority in the Senate.
{"title":"The Continuing Debate on Health Insurance Reform","authors":"S. Harrington","doi":"10.2139/SSRN.1947021","DOIUrl":"https://doi.org/10.2139/SSRN.1947021","url":null,"abstract":"This Policy Brief provides an overview of the 2010 Affordable Care Act and perspective on some of its key provisions affecting health insurance. Following a synopsis of the main problems that confront U.S. health care and insurance, it considers the extent to which the Affordable Care Act (ACA) will affect those problems, including the ACA’s minimum medical loss ratio and rate review requirements for health insurers. It discusses the economics of the individual mandate, implications of possible court rulings on the mandate’s constitutionality, and implementation of the ACA to date. It concludes with brief description of market-oriented alternatives to the ACA that will likely be considered if the Republicans win the 2012 presidential election, retain the House, and capture a sufficient majority in the Senate.","PeriodicalId":375769,"journal":{"name":"Wharton School: Health Care Management (Topic)","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122573464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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