Initial Impacts of the Patient Care Networks of Alabama Initiative.

摘要: Objectives To estimate the effects of medical home support on use clinical services and Medicaid expenditures. Data Source Medicaid claims. Study Design A difference-in-differences model where changes in utilization expenditures intervention group are compared to nonintervention group. Extraction Methods Using claims from October 2010 through September 2013, service measured for 12 months before 21 months after implementation. Changes four health status groups examined separately. Principal Findings The introduction community-based was associated with a small reduction no statistically significant overall effect expenditures. However, among those chronic and/or mental conditions, there were modest, increases range ambulatory inpatient care services, while without these conditions declined. Emergency department increased all groups. Conclusions Community-based practices is shift mix provided higher cost, more vulnerable subgroups Medicaid. Such systems unlikely be cost savings, at least short term, but may have other benefits.