[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Invited Commentary
Health Policy
February 5, 2020

The Patient-Centered Medical Home and the Challenge of Evaluating Complex Interventions

Author Affiliations
  • 1Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 2Center for Primary Care, Harvard Medical School, Boston, Massachusetts
  • 3Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
  • 4Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
JAMA Netw Open. 2020;3(2):e1920827. doi:10.1001/jamanetworkopen.2019.20827

The study by Reddy and colleagues1 reports on an analysis of the Patient Aligned Care Team (PACT) initiative, a patient-centered medical home (PCMH) initiative from the US Department of Veterans Affairs (VA) and one of the largest PCMH initiatives in the country. Involving more than 1 million patients during 4 years (2012-2015), the study tapped into the extensive databases of the VA, including results from surveys of patients and staff specifically designed to capture elements of PCMH. Reddy et al1 examined the association of longitudinal changes in PCMH implementation with 3 high-cost health care utilization outcomes: emergency department (ED) visits, hospitalizations for ambulatory care–sensitive conditions (ACSCs), and all-cause hospitalizations. They found no consistent association of more robust PCMH implementation with better outcomes.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words