Study finds PCMHs improve cancer screening rates

Blue Cross Blue Shield (BCBS) of Michigan’s Patient-Centered Medical Home (PCMH) model improved overall cancer screening rates for colon, breast and cervical cancer, according to a study published last month in JAMA Internal Medicine.

The three-year longitudinal study reviewed breast, cervical and colon cancer screening rates of 2,218 practices across the state providing care for a wide variety of socioeconomic groups. Researchers set out to find whether improved cancer screening occurred within the PCMH model, and whether the improvement was dependent on the socioeconomic context in which the physician practiced.

“Smaller practices and practices operating in disadvantaged areas face additional challenges that larger, well-funded practices typically don’t. So we wanted to see whether the effects of PCMH were uniform across practice environments, or whether the model has differing benefits based on where it is implemented,.” said David Share, M.D., MPH, BCBSM senior vice president for Value Partnerships.

Results showed improved cancer screening rates across all socioeconomic contexts, and the disparity in cancer screening rates among patients in high and low socioeconomic groups significantly narrowed in practices where the PCMH model was fully implemented.

“Because the effects of the PCMH model appear to vary by socioeconomic context, executives should take into consideration their population when assessing the potential benefits from a PCMH program,” says Share. “Supporting providers in developing and implementing the patient centered medical home model may improve your bottom line as well as improve patient outcomes.” 

NEXT: Program reduces hospital stays and ER visits

BCBSM’s Patient-Centered Medical Home program is the largest of its kind in the nation, and has shown to improve patient health and outcomes. The program achieved certified savings of $155 million in prevented ER and hospital claims from the first three years of the PCMH designation program.

Data from 2013-2014 shows adult patients in Blue-designated PCMH practices had a 27.5% lower rate of hospital stays for certain conditions than non-designated practices, and a 9.9% lower rate of ER visits over non-PCMH doctors.

In the PCMH model, physician-led care teams coordinate and track patients' healthcare including non-clinical factors such as emotional, behavioral and social needs that may influence a person’s health. In July 2014, BCBS of Michigan announced it designated 1,422 practices, comprised of more than 4,020 physicians, as PCMHs. These practices had made the most progress toward implementing the various capabilities of a PCMH model.

“The impacts of the PCMH model are stronger in areas traditionally disadvantaged under the old system, most likely because of improved access to care with the PCMH model,” notes Share. "If adequately resourced, the PCMH model may improve health equity.”

Cancer screenings should ideally catch cancers in their earliest, most treatable stages, which improves outcomes, enables cancers to be treated early before major illness or complications set in, and costs less to treat, according to Share. “One of the goals of our PCMH model is to improve preventive care including cancer screenings.”