In 2010 the Veterans Health Administration (VHA) began a nationwide initiative called Patient Aligned Care Teams (PACT) that reorganized care at all VHA primary care clinics in accordance with the patient-centered medical home model. The researchers in this article published in Health Affairs analyzed data for fiscal years 2003–12 to assess how trends in health care use and costs changed after the implementation of PACT. They found that PACT was associated with “modest increases in primary care visits and with modest decreases in both hospitalizations for ambulatory care–sensitive conditions and outpatient visits with mental health specialists.” The researchers found that the PACT model did not produce a positive return on investment in terms of the cost, but they noted that “trends in costs and use are favorable. Adopting patient-centered care does not appear to have been a major financial risk for the VHA.”
As stated by the authors of the article, “An organization’s decision to adopt the patient-centered medical home model should be based not upon unrealistic expectations of substantial cost savings but upon expected benefits, such as improved quality of care and high satisfaction with care. Over time, however, there may well be incremental savings.” This statement about ROI versus quality of care is a consistent thread throughout the latest PCMH impact research.