Pharmacists on Medical Home Teams May Help Improve Results

Will a study finding little benefit from patient-centered medical homes delay the involvement of pharmacists or hasten it due to the implication that new players are needed to produce better results?

“Tell me it isn’t true!” was my thought when I read a recent Wall Street Journal article about a study on patient-centered medical homes carried out by researchers from the RAND Corporation and published in the February 26, 2014, issue of the Journal of the American Medical Association.

Here’s the portion of the article that troubled me: “[A] study of one of the earliest and largest medical-home pilots found that after three years, patients’ health improved in only 1 of 11 measures. There was no change in hospital or emergency room use, and no significant cost savings.”

We all know that proponents of the Affordable Care Act (ACA) have been counting on saving money by providing better coordinated care. Then, it has been supposed, we would be able to offer care to more patients without increasing overall costs. Was this premise misguided, or is it just too early in the ACA process to see results?

One explanation the article provides for the lack of improvement demonstrated by medical homes in the pilot is that they were rewarded for winning National Committee for Quality Assurance recognition rather than for improving patient outcomes. Pharmacy has put great hope in becoming part of the medical home model and in playing a greater role in the management of chronic disease generally. Will studies such as this one delay our involvement, or will they hasten it due to the implication that new players are needed to produce better results? What do you think?