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A new analysis finds that total healthcare costs and ED visits are significantly lower for adult patients of Patient-Centered Medical Homes (PCMHs) than for Accountable Care Organizations (ACOs), hybrids (both PCMHs and ACOs), or standard care (from facilities that are neither).

PCMH patients had the lowest average total cost of care, 23% lower than standard care. ACOs and hybrid (PCMH+ACO) models saved only 15% and 14%, respectively, from standard care. Most of the PCMH savings came from lower inpatient costs. PCMH patients were also the least likely to visit an ER, 26% less than standard care. The results held after adjustment for socioeconomic factors.

PCMHs are certified primary care practices that deliver care differently, emphasizing care coordination and improved access. PCMHs are compensated for their extra costs. ACOs emphasize collaboration across all providers through voluntary contracting but rely on financial incentives, usually shared savings, to reduce patients’ total costs of care. There are few standards, certifications or oversight for ACOs.

Policymakers should take note that, despite the emphasis on savings, ACOs perform worse than PCMHs in lowering costs.