Specialized Primary Care Medical Home: A Positive Impact on Continuity of Care among Autistic Adults

While the medical home has proven effective at improving continuity of care among other populations, there is a paucity of literature testing the effectiveness of medical homes in serving the healthcare needs of autistic adults. We conducted a retrospective cohort study to compare the continuity of care of autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the Center for Autism Services and Transition (CAST), to propensity score matched national samples of autistic adults with private insurance or Medicare. The unadjusted median Bice-Boxerman continuity of care index was 0.6 (interquartile range = 0.4-1.0) for CAST patients, 0.5 (interquartile range = 0.3-1.0) for Medicare beneficiaries, and 0.6 (interquartile range = 0.4-1.0) for privately insured autistic adults. In multivariable models controlling for demographic characteristics, on average, CAST patients had continuity of care indices that were 10% higher than national samples of autistic adult Medicare beneficiaries (p < 0.0001). Continuity of care among CAST patients did not significantly differ from that of the national sample of privately insured autistic adults (p = 0.08). Our findings suggest that medical homes, like CAST, may be a promising solution to improve healthcare delivery for the growing population of autistic adults.