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Center for Health Services and Outcomes Research

Patient Outcomes – Patient Reported

Maryland Multi-Payor Patient Centered Medical Home Program Evaluation

The Maryland Health Care Commission (MHCC) launched the Maryland Multi-Payor Patient Centered Medical Home Program (MMPP) as a 3-year pilot demonstration with 52 selected primary care practices on April 14, 2011. The evaluation assesses the impact of the PCMH model on the following domains: 1) practice transformation; 2) provider satisfaction; 3) patient satisfaction and experience, including access to care; 4) quality, utilization and costs of care. The evaluation design combines quantitative and qualitative methods, including: 1) site visits at 9 selected MMPP practices with key informant interviews about infrastructure changes, experiences, satisfaction with the transformation process and its outcomes; 2) MMPP patient telephone surveys using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) PCMH Survey, the CAHPS supplemental topic areas, and the Patient Assessment of Chronic Illness Care (PACIC); 3) MMPP provider web-based surveys with questions primarily from a question bank developed by the Commonwealth Fund’s PCMH Evaluators' Collaborative; 4) Patient administrative claims data analysis to generate practice-level measures of quality, utilization and costs. Provider surveys and administrative data portions of the evaluation use comparison practices, which were chosen to be as much like the MMPP practices as possible using propensity score matching. Matching variables included practice characteristics, provider characteristics aggregated at practice level, and characteristics of practice location. Patient surveys and practice site visits have no comparison group. A difference-in-difference design is used to demonstrate changes in outcomes from baseline to third program year. Results will be available online from MHCC.

Products:

Marsteller, JA, Hsu, Y-J, Gill, C, Kiptanui, Z, Fakeye, OA, Engineer, LD, Perlmutter, D, Khanna, N, Rattinger, GB, Nichols, D, Harris, I. Maryland Multipayor Patient-centered Medical Home Program: A 4-Year Quasiexperimental Evaluation of Quality, Utilization, Patient Satisfaction, and Provider PerceptionsMedical Care. 2018;56(4):308-320. doi:10.1097/MLR.0000000000000881.

Formative Evaluations of Cost, Quality and Access within a Statewide Multi-Payor Patient-Centered Medical Home Program.

Evaluation of the Maryland Multi-Payer Patient Centered Medical Home Program - Final Report.