Do Medical Homes Improve Quality of Care for Persons with Multiple Chronic Conditions?

Karen E. Swietek, Marisa Elena Domino, Christopher Beadles, Alan R. Ellis, Joel F. Farley, Lexie R. Grove, Carlos Jackson, C. Annette DuBard

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objective: To examine the association between medical home enrollment and receipt of recommended care for Medicaid beneficiaries with multiple chronic conditions (MCC). Data Sources/Study Setting: Secondary claims data from fiscal years 2008–2010. The sample included nonelderly Medicaid beneficiaries with at least two of eight target conditions (asthma, chronic obstructive pulmonary disease, diabetes, hypertension, hyperlipidemia, seizure disorder, major depressive disorder, and schizophrenia). Study Design: We used linear probability models with person- and year-level fixed effects to examine the association between patient-centered medical home (PCMH) enrollment and nine disease-specific quality-of-care metrics, controlling for selection bias and time-invariant differences between enrollees. Data Collection Methods: This study uses a dataset that links Medicaid claims with other administrative data sources. Principal Findings: Patient-centered medical home enrollment was associated with an increased likelihood of receiving eight recommended mental and physical health services, including A1C testing for persons with diabetes, lipid profiles for persons with diabetes and/or hyperlipidemia, and psychotherapy for persons with major depression and persons with schizophrenia. PCMH enrollment was associated with overuse of short-acting β-agonists among beneficiaries with asthma. Conclusions: The PCMH model can improve quality of care for patients with multiple chronic conditions.

Original languageEnglish (US)
Pages (from-to)4667-4681
Number of pages15
JournalHealth services research
Issue number6
StatePublished - Dec 2018

Bibliographical note

Funding Information:
Joint Acknowledgment/Disclosure Statement: This work was funded by the Agency for Healthcare Research and Quality (Grant No. R24 HS019659-01). Dr. DuBard and Dr. Jackson were employed by Community Care of North Carolina (CCNC) during the conduct of this research. CCNC operates the medical home program that is the subject of this analysis. The authors report no other relevant financial interests pertaining to this manuscript. Disclosures: None. Disclaimer: None.

Publisher Copyright:
© Health Research and Educational Trust


  • Medical homes
  • chronic conditions
  • multimorbidity
  • quality


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