|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$75||Benefits minus costs||$66|
|Participants||$24||Benefit to cost ratio||$1.80|
|Others||$92||Chance the program will produce|
|Indirect||($42)||benefits greater than the costs||45 %|
|Net program cost||($83)|
|Benefits minus cost||$66|
|Detailed Monetary Benefit Estimates Per Participant|
|Benefits from changes to:1||Benefits to:|
|Health care (total costs)||$75||$24||$92||$0||$191|
|Adjustment for deadweight cost of program||$0||$0||$0||($42)||($42)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$83||2016||Present value of net program costs (in 2016 dollars)||($83)|
|Comparison costs||$0||2016||Cost range (+ or -)||16 %|
|Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)|
|The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.|
|Meta-Analysis of Program Effects|
|Outcomes measured||Treatment Age||No. of effect sizes||Treatment N||Adjusted effect sizes (ES) and standard errors (SE) used in the benefit-cost analysis||Unadjusted effect size (random effects model)|
|First time ES is estimated||Second time ES is estimated|
|Emergency department visits*||68||5||178888||-0.074||0.029||68||0.000||0.000||69||-0.074||0.011|
|Health care costs*||68||3||149593||-0.025||0.036||68||0.000||0.000||69||-0.025||0.491|
Boult, C., Leff, B., Boyd, C.M., Wolff, J.L., Marsteller, J.A., Frick, K.D., . . . Scharfstein, D.O. (2013). A matched-pair cluster-randomized trial of guided care for high-risk older patients. Journal of General Internal Medicine, 28(5), 612-621.
David, G., Gunnarsson, C., Saynisch, P.A., Chawla, R., & Nigam, S. (2014). Do patient-entered medical homes reduce emergency department visits? Health Services Research, 5.
Rosenthal, M.B., Alidina, S., Friedberg, M.W., Singer, S.J., Eastman, D., Li, Z., & Schneider, E.C. (2016). Impact of the Cincinnati aligning forces for quality multi-payer patient centered medical home pilot on health care quality, utilization, and costs. Medical Care Research and Review, 73(5), 532-45.
van Hasselt, M., McCall, N., Keyes, V., Wensky, S.G., & Smith, K.W. (2014). Total cost of care lower among Medicare fee-for service beneficiaries receiving care from patient-centered medical homes. Health Services Research, 50(1), 253-272.
Wang, Q.C., Chawla, R., Colombo, C.M., Snyder, R.L., & Nigam, S. (2014). Patient-centered medical home impact on health plan members with diabetes. Journal of Public Health Management and Practice, 20(5), E12-E20.