Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?

Medical Care
Jeongyoung ParkPatricia Pittman

Abstract

Few studies have looked under the hood of practice redesign to understand whether and, if so, how staffing changed with the adoption of patient-centered medical home (PCMH), and whether these staffing changes impacted utilization. To examine the workforce transformation occurring in community health centers that have achieved PCMH status, and to assess the relationship of those changes to utilization, as measured by the number of visits. Using a difference-in-differences approach, we compared staffing and utilization outcomes in 450 community health centers that had adopted a PCMH model between 2007 and 2013 to a matched sample of 243 nonadopters located in the 50 states and the District of Columbia. We found that adopting a PCMH model was significantly associated with a growth in use of advanced practice staff (nurse practitioners and physician assistants) [0.53 full-time equivalent (FTE), 8.77%; P<0.001], other medical staff (medical assistants, nurse aides, and quality assurance staff) (1.23 FTE, 7.46%; P=0.001), mental health/substance abuse staff (0.73 FTE, 17.63%; P=0.005), and enabling service staff (case managers and health educators) (0.36 FTE, 6.14%; P=0.079), but not primary care physicians or nurses. We did not obse...Continue Reading

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Citations

May 31, 2019·International Journal of Environmental Research and Public Health·Gonzalo Duarte-ClimentsJuan Gómez-Salgado
Jun 2, 2021·Nursing Administration Quarterly·Patricia PittmanDeborah Trautman
Sep 21, 2021·Journal of Primary Care & Community Health·Daniel A NagelIsdore Chola Shamputa
Nov 14, 2020·Medical Care Research and Review : MCRR·Hilary BarnesMichael R Richards

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