DPC News

STUDY: “High-touch” [Concierge Medicine] care improves outcomes and lowers costs in at-risk seniors.

High-Touch Care Leads to Better Outcomes and Lower Costs in a Senior Population

By Reyan Ghany, MD; Leonardo Tamariz, MD, MPH; Gordon Chen, MD; Elissa Dawkins, MS; Alina Ghany, MD; Emancia Forbes, RDCS; Thiago Tajiri, MBA; and Ana Palacio, MD, MPH

Evaluating the impact of a high-touch primary care model among a Medicare Advantage population in comparison with a standard practice–based model.

ABSTRACT

Objectives: There are several models of primary care. A form of high-intensity care is a high-touch model that uses a high frequency of encounters to deliver preventive services. The aim of this study is to compare the healthcare utilization of patients receiving 2 models of primary care, ​1 with high-touch care and 1 without.

Study Design: Retrospective cohort study.

Methods: We conducted a retrospective cohort study of 2 models of care used among Medicare Advantage populations. Model 1 is a high-touch care model, and model 2 is a standard care model. Compared with model 2, model 1 has smaller panel sizes and a higher frequency of encounters. We compared patients’ healthcare utilization and hospitalizations between both models using a propensity score–matched analysis, matching by Charlson Comorbidity Index (CCI) score, age, and gender.

Results: We included 17,711 unmatched Medicare Advantage primary care patients and matched 5695 patients from both models of care. CCI scores, age, and gender were similar between both matched groups (P >.05). The median total per member per month healthcare costs in model 1 were $87 (95% CI, $26-$278) compared with $121 (95% CI, $52-$284) in model 2 (P <.01). The mean number of hospital admissions was lower in model 1 (0.10 ± 0.40) compared with model 2 (0.20 ± 0.58). The number of primary care physician visits and preventive medication use were higher in model 1 (P <.05 for both).

Conclusions: In a propensity-matched sample of Medicare Advantage patients, those receiving high-touch care had lower healthcare costs and fewer hospitalizations. Potential explanations are higher preventive medication use and more frequent visits.

Am J Manag Care. 2018;24(9):e300-e304

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