Worksite medical home: health services use and claim costs.
Repository Usage Stats
OBJECTIVES: To examine the relationship among use of an on-site employer-provided primary care medical home, and health services use and health plan costs for inpatient and outpatient services and pharmaceuticals. STUDY DESIGN: The study was a retrospective observational analysis of health plan claims, human resources data, and Health Care Center (HCC) encounters. METHODS: Three years of data for employees and dependents designating the HCC as their primary care provider (HCC major users) were compared with data from 2 comparison groups: "casual" HCC users and HCC nonusers. The outcomes of interest were: 1) health services utilization, and 2) monetized use of the health plan. Secondary data from an employer-provided Health Care Center (HCC). RESULTS: After adjusting for several potential confounders, HCC major users had less use of external healthcare services than the comparison groups (employees had 2.7 fewer external encounters than HCC casual users [P < .001] and 1.2 fewer external encounters than nonusers [P < .001]; dependents had 3.5 fewer external encounters than HCC casual users [P < .001] and 1.9 fewer external encounters than non-users [P < .001]). Annual monetized use of the health plan for employees and dependents was highest for HCC casual users relative to HCC major users (employees: $482 greater, P < .01; dependents: $598 greater, P < .001). CONCLUSIONS: Employees and their dependents who were "casual users" of the HCC had the highest claims costs and use of outside healthcare services. Additional research is needed to assess the extent to which employees' utilization of services at on-site primary care medical homes affects employee health outcomes, resulting in potential effects on company healthcare plan expenditures, worker productivity, and return on investment.
Continental Population Groups
Health Benefit Plans, Employee
Insurance Claim Review
Primary Health Care
More InfoShow full item record
Dir, Research Initiatives
My overarching goal is to facilitate effective research and collaborations for the Duke research community, through the delivery of targeted programs and individual consultations.
Alphabetical list of authors with Scholars@Duke profiles.
Showing items related by title, author, creator, and subject.
Stoertz, Aaron (2011)Health system strengthening is now recognized as a pressing global health priority. Motivated and productive health workers are a critical component of health systems. Low and middle-income countries need many more health ...
Loh, Hwee Min (2015)Contraceptive prevalence in Haiti remains low despite extensive foreign aid targeted at improving family planning.  Earlier studies have found that peer-informed learning have been successful in promoting sexual ...
Optimizing linkage and retention to hypertension care in rural Kenya (LARK hypertension study): study protocol for a randomized controlled trial. Vedanthan, Rajesh; Kamano, Jemima H; Naanyu, Violet; Delong, Allison K; Were, Martin C; Finkelstein, Eric A; Menya, Diana; ... (16 authors) (Trials, 2014-04-27)BACKGROUND: Hypertension is the leading global risk factor for mortality. Hypertension treatment and control rates are low worldwide, and delays in seeking care are associated with increased mortality. Thus, a critical component ...