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- Title
Impact of a Statewide Multi-Payer Patient-Centered Medical Home Program on Antihypertensive Medication Adherence.
- Authors
Fakeye, Oludolapo A.; Khanna, Niharika; Hsu, Yea-Jen; Marsteller, Jill A.
- Abstract
Evidence suggests that the patient-centered medical home (PCMH) model of primary care improves management of chronic disease, but there is limited research contrasting this model's effect when financed by a single payer versus multiple payers, and among patients with different types of health insurance. This study evaluates the impact of a statewide medical home demonstration, the Maryland Multi-Payer PCMH Program (MMPP), on adherence to antihypertensive medication therapy relative to non-PCMH primary care and to the PCMH model when financed by a single payer. The authors used a difference-in-differences analytic design to analyze changes in medication possession ratio for antihypertensive medications among Medicaid-insured and privately insured non-elderly adult patients attributed to primary care practices in the MMPP ("multi-payer PCMHs"), medical homes in Maryland that participated in a regional PCMH program funded by a single private payer ("single-payer PCMHs"), and non-PCMH practices in Maryland. Comparison sites were matched to multi-payer PCMHs using propensity scores based on practice characteristics, location, and aggregated provider characteristics. Multi-payer PCMHs performed better on antihypertensive medication adherence for both Medicaid-insured and privately insured patients relative to single-payer PCMHs. Statistically significant effects were not observed consistently until the second year of the demonstration. There were negligible differences in outcome trends between multi-payer medical homes and matched non-PCMH practices. Findings indicate that health care delivery innovations may yield superior population health outcomes under multi-payer financing compared to when such initiatives are financed by a single payer.
- Subjects
MARYLAND; ANTIHYPERTENSIVE agents; INSURANCE companies; EVALUATION of medical care; HYPERTENSION; CONFIDENCE intervals; PATIENT-centered care; MEDICAL care; PRIVATE sector; RETROSPECTIVE studies; REGRESSION analysis; HEALTH insurance reimbursement; PRIMARY health care; DRUGS; REPEATED measures design; DESCRIPTIVE statistics; PATIENT compliance; MEDICAID; DATA analysis software; EVALUATION
- Publication
Population Health Management, 2022, Vol 25, Issue 3, p309
- ISSN
1942-7891
- Publication type
Article
- DOI
10.1089/pop.2021.0172