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Tag: Vermont Blueprint for Health

More Evidence That Patient Centered Medical Homes Don’t Work

A state the size of Vermont claiming savings of $120,000,000 through a patient-centered medical home (PCMH) program should raise eyebrows.

North Carolina made similar claims about its PCMH model, only to have the results so thoroughly debunked that consulting firm, Milliman, was forced to retract its key assertion.

I expect more from Vermont, if only because I’m a Democrat and Vermont has turned so “blue” that in 2008 John McCain received only 10,000 more votes than Calvin Coolidge garnered in 1924.  However, it turns out red states don’t have a monopoly on invalid PCMH data.

A brief summary of the Vermont Blueprint for Health, as described in the enabling legislation, would be: “a program for integrating a system of healthcare for patients, improving the health of the overall population…by promotion health maintenance, prevention, and care coordination and management.”

This is to be achieved by emphasizing the usual suspects — patient-centered medical homes and various support mechanisms for them.   The idea is to achieve “a reduction in avoidable acute care (emergency visits and inpatient admissions).”

Growth in participation has been phenomenal. In 2009, only a few practices and a dozen employees were involved, so we can call that the baseline year.  The report’s findings take us through 2012, by the end of which two-thirds of the state’s primary care practices (104) and population (423,000) were involved, along with 114 full-time employees.

The State’s Analysis

Through the end of 2012, the state — by using the classic fallacy (also embraced by the wellness industry) of comparing participants to non-participants — was able to show savings of $120,000,000 and a double-digit ROI.

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