This research analyzes the cost-efficiency of the Patient Centered Medical Home (PCMH) model vis-à-vis the traditional care delivery model in the Federally Qualified Health Centers (FQHC). We apply the three-stage least squares modeling approach on 2014 UDS data on all FQHCs to estimate per-visit and per-patient cost functions. Log-quadratic and linear-quadratic functional forms of cost are used for the analysis. The estimated models reveal substantial scale economies and cost advantages associated with PCMH status. Aggregate cost-saving impact of PCMH across all FQHCs in 2014 is estimated to be $1.05 billion. Simulations reveal that the PCMH impact on cost savings grows with the size of the patient population. Reaching the full cost-saving potential in PCMH-recognized FQHCs hinges on expanding the health workforce at all levels of care to meet the need of the growing patient population due to aging and Medicaid expansion. For FQHCs that are not PCMH-recognized, capacity/infrastructural expansion appears to be the immediate policy choice.

本研究分析了以患者为中心的医疗之家 (PCMH) 模式与联邦合格医疗中心 (FQHC) 中的传统护理提供模式相比的成本效益。我们对所有 FQHC 的 2014 年 UDS 数据应用三阶段最小二乘建模方法来估计每次访问和每个患者的成本函数。成本的对数二次和线性二次函数形式用于分析。估计模型揭示了与 PCMH 状态相关的大规模经济和成本优势。2014 年 PCMH 对所有 FQHC 的总成本节约影响估计为 10.5 亿美元。模拟显示 PCMH 对成本节约的影响随着患者人数的增加而增加。在 PCMH 认可的 FQHC 中实现全部成本节约潜力取决于扩大各级护理的卫生人力，以满足由于老龄化和医疗补助扩张而不断增长的患者人口的需求。对于未被 PCMH 认可的 FQHC，产能/基础设施扩张似乎是直接的政策选择。