The effects of home-based primary care on Medicare costs at Spectrum Health/Priority Health (Grand Rapids, MI, USA) from 2012-present: a matched cohort study

Table 3 Medicare allowed costs during follow-up – participants and controls matched for mortality

			N	Total cost	RX cost (% total)	IP cost (% total)	OP cost (% total)	Savings, 95% CI, p-value
12 months	Alive	HBPC	176	$28,373	$5394 (19.01%)	$9272 (32.68%)	$7041 (24.82%)	($5866) ($10,606), ($1125) p = 0.015
	Alive	Ctrl	176	$22,507	$4833 (21.69%)	$8358 (37.13%)	$3960 (17.59%)	($5866) ($10,606), ($1125) p = 0.015
	Dead	HBPC	20	$21,273	$1847 (8.68%)	$10,138 (47.66%)	$5373 (25.25%)	$37,037 $11,552, $62,522 p = 0.006
	Dead	Ctrl	20	$58,310	$4174 (7.16%)	$38,119 (65.37%)	$4253 (7.29%)	$37,037 $11,552, $62,522 p = 0.006
24 months	Alive	HBPC	161	$41,716	$6219 (14.91%)	$13,381 (32.08%)	$12,398 (29.72%)	$726 ($6464), $7916 p = 0.84
	Alive	Ctrl	161	$42,442	$8832 (20.81%)	$14,193 (33.44%)	$8815 (20.77%)	$726 ($6464), $7916 p = 0.84
	Dead	HBPC	31	$28,116	$2154 (7.66%)	$12,516 (44.51%)	$7907 (28.12%)	$27,610 $8077, $47,142 p = 0.007
	Dead	Ctrl	31	$55,726	$4214 (7.56%)	$30,732 (55.14%)	$8800 (15.79%)	$27,610 $8077, $47,142 p = 0.007

Table 3 provides patterns of medical costs and savings for matched (conditional on mortality status) HBPC participant and control samples at 12 and 24 months. HBPC participants show substantial savings at end of life relative to controls, driven strongly by reductions in in-patient costs. Prior to end of life, HBPC participants are more expensive initially, and cost neutral after the first 12 months of enrollment

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