Evaluation of the Massachusetts Patient-Centered Medical Home Initiative

Monday, January 25, 2016

Situation

The Massachusetts Executive Office of Health and Human Services launched a three-year, multi-payer demonstration project in 2011 to implement the Patient-Centered Medical Home (PCMH) model in selected primary care practice sites. UMass Medical School undertook an evaluation of the initiative using multiple data sources to understand the extent to which practices transform to become medical homes. The evaluation team was led by Dr. Ann Lawthers, Director of Quality for MassHealth, Office of Clinical Affairs at the Medical School.

A total of 46 participating primary care practices received an intervention as part of the transformation initiative, and an additional 22 practices were selected to serve as comparison sites for purposes of evaluation.

Solution

In collaboration with the evaluation team, the Office of Survey Research implemented patient experience and staff member surveys to address the research objectives.

Patient Experience Survey:

  • Assessed both adult and pediatric patient experiences; adapted from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) PCMH instruments.
  • Sampled 19,131 and 20,652 patients from both intervention and comparison practices in Spring 2013 and Spring 2014, respectively.
  • Conducted in both English and Spanish through a two-wave mail protocol, with telephone follow-up for non-respondents.

Staff Member Survey:

  • Adapted from several surveys used to evaluate national demonstrations of patient-centered medical home transformations.
  • Staff members from intervention and comparison practices were surveyed at three points in time (Fall 2011, Spring 2013 and Spring 2014) to assess change over time.
  • Conducted online with email invitations and reminders to staff members.

Results

The Office of Survey Research prepared practice-level reports for both the patient experience and staff member surveys, showing the practice’s performance over time and a comparative analysis versus other practices. The results provide primary care practices with data to guide internal quality improvement and other performance initiatives. In addition, the evaluation team is using the survey results to measure the extent to which the intervention practices transformed to the PCMH model.