Do Medical Homes Offer Improved Diabetes Care for Medicaid Enrollees with Co-occurring Schizophrenia?

Purpose: To determine whether Medicaid recipients with co-occurring diabetes and schizophrenia that are medical-home-enrolled are more likely to receive guideline-concordant diabetes care than those who are not medical-home-enrolled, controlling for confounders.

Methods: We used administrative data on adult, non-dually eligible North Carolina Medicaid beneficiaries with diagnoses of both diabetes and schizophrenia (N= 3,897) for fiscal years 2008-2010. We evaluated the relationship between medical-home-enrollment and receipt of recommended diabetes care reimbursed by Medicaid (lipid profiles, HbA1c tests, medical attention for nephropathy, and eye exams for those over 30), using fixed-effects regression models on person-month level data.

Results: There was a statisti-cally significant, positive effect of medical home enrollment on receipt of Medicaid-funded eye exams, HbA1c tests, and medical attention for nephropathy, but not receipt of lipid profiles.

Conclusions: For Medicaid enrollees with diabetes and schizophrenia, medical home enrollment is generally associated with greater likelihood of receiving guideline-concordant diabetes care.