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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 643 Research Studies Displayed
Dixit RA, Ratwani RM, Bishop JA
The impact of expanded telehealth availability on primary care utilization.
This study examined the impact of telehealth availability due to the COVID-19 pandemic and whether it may result in an unnecessary increase in utilization. The authors analyzed 4,114,651 primary care encounters from three healthcare systems between 2019 and 2021 and found little change in telehealth utilization as it became widely available.
AHRQ-funded; HS028255.
Citation:
Dixit RA, Ratwani RM, Bishop JA .
The impact of expanded telehealth availability on primary care utilization.
NPJ Digit Med 2022 Sep 9;5(1):141. doi: 10.1038/s41746-022-00685-8..
Keywords:
Telehealth, Health Information Technology (HIT), Primary Care, Healthcare Utilization
Grauer A, Duran AT, Liyanage-Don NA
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
The purpose of this retrospective cohort study was to explore whether there is a relationship between telemedicine use in primary care and risk factor assessment and control for patients with diabetes mellitus. The study included patients with diabetes mellitus ages 18-75 with a telemedicine visit in a primary care network between February 2020 and December 2020. Researchers evaluated whether low-density lipoprotein cholesterol (LDL-C), blood pressure (BP), and hemoglobin A1c (HbA1c) and were assessed for each patient. The study identified 1,824 patients with diabetes during the study period and found that telemedicine use was associated with a lower proportion of patients with all three risk factors assessed. The researchers concluded that telemedicine use was related with gaps in risk factor assessment for patients with diabetes during the COVID-19 pandemic.
AHRQ-funded; HS026121; HS024262.
Citation:
Grauer A, Duran AT, Liyanage-Don NA .
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
J Endocrinol Invest 2022 Sep;45(9):1749-56. doi: 10.1007/s40618-022-01814-6..
Keywords:
Diabetes, Chronic Conditions, Telehealth, Health Information Technology (HIT), Primary Care, Risk
Fraze TK, Lewis VA, Wood A
Configuration and delivery of primary care in rural and urban settings.
This study examined configuration and delivery of rural primary care of Medicare beneficiaries compared to more urban settings. The study included over 27 million participants with qualifying visits who were assigned to practices. The authors characterized practices’ structures, capabilities, and payment reform participation and measured beneficiary utilization by rurality. Rural practices were smaller, more primary care dominant and system owned with more beneficiaries per practice. Rural area beneficiaries were more likely to be from high-poverty areas and disabled. There was less engagement in quality-focused payment programs than in metropolitan practices. There was less preventive care, such as fewer beneficiaries with diabetes receiving an eye exam, fewer mammograms, and higher overall and condition-specific readmissions. While most isolated beneficiaries traveled to more urban practices for outpatient care, those receiving care in rural practices had similar outpatient and inpatient utilization to urban counterparts except for readmissions and quality metrics that rely on services outside of primary care.
AHRQ-funded; HS024075.
Citation:
Fraze TK, Lewis VA, Wood A .
Configuration and delivery of primary care in rural and urban settings.
J Gen Intern Med 2022 Sep;37(12):3045-53. doi: 10.1007/s11606-022-07472-x..
Keywords:
Primary Care, Healthcare Delivery, Rural Health, Urban Health, Medicare
Fraze TK, Beidler LB, Gottlieb LM
A missed opportunity? How health care organizations engage primary care clinicians in formal social care efforts.
The purpose of this study was to explore how health care organizations include clinicians in formal social care efforts. Administrators of 29 health care organizations participated in 33 semi-structured interviews in 2019. Administrators were hesitant to increase primary care providers' responsibilities with social care activities, but believed clinicians could engage in social care programs in 4 ways: 1) Strengthen relationships with patients by discussing social risks; 2) adjust follow-up clinical care plans based on social risks; 3) adapt prescriptions based on social risks; and (4) refer patients to other care team members who can directly assist with social risks.
AHRQ-funded; HS024075.
Citation:
Fraze TK, Beidler LB, Gottlieb LM .
A missed opportunity? How health care organizations engage primary care clinicians in formal social care efforts.
Popul Health Manag 2022 Aug;25(4):509-16. doi: 10.1089/pop.2021.0306..
Keywords:
Primary Care, Provider: Clinician, Social Determinants of Health
Pestka DL, Paterson NL, Brummel AR
Barriers and facilitators to implementing pharmacist-provided comprehensive medication management in primary care transformation.
The objective of this study was to identify barriers and facilitators when integrating pharmacist-provided comprehensive medication management (CMM) services into a health system's team-based primary care transformation (PCT) using the Consolidated Framework for Implementation Research. Findings showed that identifying and addressing implementation barriers and facilitators early during PCT rollout was critical to the success of team-based services such as CMM and becoming a learning health system. Further, clinical pharmacists providing CMM represented a valuable interdisciplinary care team member who can help to improve healthcare quality and access to primary care.
AHRQ-funded; HS026379.
Citation:
Pestka DL, Paterson NL, Brummel AR .
Barriers and facilitators to implementing pharmacist-provided comprehensive medication management in primary care transformation.
Am J Health Syst Pharm 2022 Jul 22;79(15):1255-65. doi: 10.1093/ajhp/zxac104..
Keywords:
Medication, Provider: Pharmacist, Primary Care, Implementation, Practice Improvement
Salloum RG, Bilello L, Bian J
Study protocol for a type III hybrid effectiveness-implementation trial to evaluate scaling interoperable clinical decision support for patient-centered chronic pain management in primary care.
The objective of this 3-year project is to study the adaptation and implementation of an existing interoperable clinical decision support (CDS) tool for pain treatment shared decision making, with tailored implementation support, in new clinical settings in the OneFlorida Clinical Research Consortium. The evaluation will be organized by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, with an adaptation and tailoring of PainManager, an open source interoperable CDS tool. It is anticipated that this evaluation will establish the feasibility and obtain preliminary data in preparation for a multi-site pragmatic trial targeting the effectiveness of PainManager and tailored implementation support on shared decision making and patient-reported pain and physical function.
AHRQ-funded; R18 HS028584.
Citation:
Salloum RG, Bilello L, Bian J .
Study protocol for a type III hybrid effectiveness-implementation trial to evaluate scaling interoperable clinical decision support for patient-centered chronic pain management in primary care.
Implement Sci 2022 Jul 15;17(1):44. doi: 10.1186/s13012-022-01217-4..
Keywords:
Clinical Decision Support (CDS), Pain, Chronic Conditions, Primary Care, Health Information Technology (HIT), Patient-Centered Outcomes Research, Patient-Centered Healthcare
Singh AN, Sanchez V, Kenzie ES
Improving screening, treatment, and intervention for unhealthy alcohol use in primary care through clinic, practice-based research network, and health plan partnerships: protocol of the ANTECEDENT study.
This study evaluates tailored implementation support to increase screening, brief intervention, referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) in primary care. It will explore how primary care clinics implement SBIRT and MAUD in routine practice and how practice facilitators vary implementation support across diverse clinic settings. It is anticipated that findings will inform how effectively to align implementation support to context, advance understanding of practice facilitator skill development over time, and ultimately improve detection and treatment of unhealthy alcohol use across diverse primary care clinics.
AHRQ-funded; HS027080.
Citation:
Singh AN, Sanchez V, Kenzie ES .
Improving screening, treatment, and intervention for unhealthy alcohol use in primary care through clinic, practice-based research network, and health plan partnerships: protocol of the ANTECEDENT study.
PLoS One 2022 Jun 28;17(6):e0269635. doi: 10.1371/journal.pone.0269635..
Keywords:
Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Care Management
Yu J, Wang AA, Zimmerman LP
A cohort analysis of statin treatment patterns among small-sized primary care practices.
The purpose of this retrospective cohort analysis study was to describe statin treatment patterns in small-sized primary care practices and explore the patient and practice factors that are related to lack of statin treatment. The researchers included all statin-eligible adults (13,330) who received care at one of 53 Healthy Hearts in the Heartland (H3) practices, a cardiovascular care quality improvement initiative, between 2013 and 2016. The study found that among 43% of patients (5,780), there was no record of moderate- to high-intensity statin therapy. A lack of appropriate intensity statin therapy was independently associated with the female sex, a younger age, and lower low-density lipoprotein cholesterol (LDL-C). Also associated with lower appropriate intensity statin use was a higher proportion of patients insured by Medicaid and having only family medicine trained physicians (vs. having at least one internal medicine trained physician) at the practice. A lack of appropriate intensity statin therapy was greater in independent practices than in Federally Qualified Health Centers (FQHCs). The study concluded that factors influencing lack of statin treatment vary by practice setting, emphasizing the role of approaches that are customized to individual settings.
AHRQ-funded; HS023921.
Citation:
Yu J, Wang AA, Zimmerman LP .
A cohort analysis of statin treatment patterns among small-sized primary care practices.
J Gen Intern Med 2022 Jun;37(8):1845-52. doi: 10.1007/s11606-021-07191-9..
Keywords:
Cardiovascular Conditions, Medication, Practice Patterns, Primary Care
Kowitt SD, Goldstein AO, Cykert S
A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices.
This study investigated the outcomes of an evidence-based cardiovascular disease risk reduction tool called Heart Health Now to improve rates for tobacco cessation screening and counseling in small primary care practices in North Carolina. This tool was developed as part of AHRQ’s EvidenceNow initiative. This stepped wedge, stratified, cluster randomized trial looked at 28 practices that were staffed by 10 or fewer clinicians and had an electronic health record. Heart Health Now consisted of education tools, onsite practice facilitation for a year, and a practice-specific cardiovascular population management dashboard that included monthly, measure-specific run charts to help guide quality improvement. The practices included in their analyses consisted of 78,120 patients, and 17,687 smokers. From pre- to post-intervention, screening rates significantly increased from 82.7 to 96.2%. Cessation support rates also significantly increased from 44.3% to 50.1%. Some of the practices associated with improvement included being in an academic health center or faculty, having more clinicians, and having a lower percentage of White patients.
AHRQ-funded; HS023912.
Citation:
Kowitt SD, Goldstein AO, Cykert S .
A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices.
J Prev 2022 Jun;43(3):375-86. doi: 10.1007/s10935-022-00672-5..
Keywords:
Tobacco Use, Tobacco Use: Smoking Cessation, Screening, Primary Care, Evidence-Based Practice, Heart Disease and Health, Cardiovascular Conditions
Cross WF, West JC, Crean HF
Measurement of primary care providers' suicide prevention skills following didactic education.
This study’s objective was to determine if didactic training by medical residents and nurse practitioner (NP) trainees increased their skills to assess and manage patients’ suicidal ideation, intent, and behaviors. Online didactic training was provided to 127 medical resident and NP trainees followed by a standardized patient interaction conducted to assess demonstrated suicide prevention skills (i.e., assessment of risk factors, protective factors, suicidal ideation and behavior, safety planning). Participants demonstrated only about half of the possible total skills in most domains and were least competent in assessing potential risk for suicide. Residents were rated significantly higher than NPs on observed skills.
AHRQ-funded; HS024224.
Citation:
Cross WF, West JC, Crean HF .
Measurement of primary care providers' suicide prevention skills following didactic education.
Suicide Life Threat Behav 2022 Jun;52(3):373-82. doi: 10.1111/sltb.12827..
Keywords:
Behavioral Health, Primary Care, Prevention, Education: Continuing Medical Education, Provider: Physician, Training
Meiselbach MK, Drake C, Saloner B
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
This study examined variation in access to in-network buprenorphine-prescribing primary care providers that can treat opioid use disorder among Medicaid managed care enrollees. Approximately 32.2% of Medicaid enrollees had fewer than one in-network network buprenorphine-prescribing primary care providers per 100,000 county residents. There was on average a greater number of in-network buprenorphine-prescribing primary care providers in states with higher compared with lower overdose death rates, but most enrollees lived in areas with a shortage of these providers. The authors found that a 25 percent higher network participation rate by prescribers compared with nonprescribers could improve the probability that enrollees see a prescriber by approximately 25 percent.
AHRQ-funded; HS000029.
Citation:
Meiselbach MK, Drake C, Saloner B .
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
Health Aff 2022 Jun;41(6):901-10. doi: 10.1377/hlthaff.2021.01719..
Keywords:
Medicaid, Primary Care, Access to Care, Medication, Care Management, Opioids, Substance Abuse, Behavioral Health
Petts RA, Walker BL, Hails KA
Parents' preferences for behavioral services in primary care during the COVID-19 pandemic.
The purpose of the study was to evaluate whether the COVID-19 pandemic impacted parent’s preferences and priorities for receiving behavioral health services for their young children in the pediatric primary care setting. In 5 pediatric primary care sites across the U.S., between July 2020 and January 2021, 301 parents of young children completed surveys on their preferences for behavioral subjects and methods of service delivery in primary care. The responses were compared to the responses from 396 parents who had been surveyed on the same measures in 2018. The study concluded that priorities for behavioral subjects during the pandemic were similar to parent’s priorities before the pandemic, with only one behavioral subject (child self-calming) rated significantly more important by the parents in the pandemic group than the pre-pandemic parents. The parents in the pandemic group were also significantly more interested in remote and media-based services such as mobile applications and videos than parents in the pre-pandemic group. The researchers conclude that pediatric primary care practices may wish to consider providing mobile apps, videos, and/ or other multimedia resources as part of their behavioral health services practices.
AHRQ-funded; HS022981.
Citation:
Petts RA, Walker BL, Hails KA .
Parents' preferences for behavioral services in primary care during the COVID-19 pandemic.
J Dev Behav Pediatr 2022 Jun-Jul;43(5):291-96. doi: 10.1097/dbp.0000000000001033..
Keywords:
Children/Adolescents, COVID-19, Behavioral Health, Primary Care
Fraze TK, Beidler LB, De Marchis EH
"Beyond just a supplement": administrators' visions for the future of virtual primary care services.
The purpose of this study was to examine what health care organization administrators think about the future of virtual primary care services post-pandemic. In March-April 2021, the administrators of 17 health care organizations participated in semistructured qualitative phone interviews. The researchers explored how the administrators thought their organizations would offer virtual services after the pandemic. The study found that all the participants anticipated that their organization’s virtual primary care services would exist after the pandemic, with the main goals of 1) optimizing medical services; 2) enhancing the patient experience; and 3) increasing loyalty among patients, and the primary motivation being to remain competitive and financial solvency. The researchers concluded that administrators of health care organizations are examining how virtual services can continue after the pandemic, and what roles they will play in the delivery of services.
AHRQ-funded; HS024075.
Citation:
Fraze TK, Beidler LB, De Marchis EH .
"Beyond just a supplement": administrators' visions for the future of virtual primary care services.
J Am Board Fam Med 2022 May-Jun;35(3):527-36. doi: 10.3122/jabfm.2022.03.210479..
Keywords:
Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, COVID-19
Marino M, Solberg L, Springer R
Cardiovascular disease preventive services among smaller primary care practices.
This cross-sectional study utilized linear regression modeling to examine the association of aspirin use, blood pressure control, and smoking-cessation support performance with practice characteristics that included structural attributes, practice capacity and contextual characteristics, health information technology, and patient panel demographics. Findings showed that, on average, practice performance on aspirin use, blood pressure control, and smoking-cessation support quality measures was 64% for aspirin, 63% for blood pressure, and 62% for smoking-cessation support. Practice characteristics associated with aspirin use, blood pressure control, and smoking-cessation support performance included ownership, rurality, and disruptions.
AHRQ-funded; HS023940.
Citation:
Marino M, Solberg L, Springer R .
Cardiovascular disease preventive services among smaller primary care practices.
Am J Prev Med 2022 May;62(5):e285-e95. doi: 10.1016/j.amepre.2021.10.011..
Keywords:
Cardiovascular Conditions, Primary Care, Prevention
Allen KS, Danielson EC, Downs SM
Evaluating a prototype clinical decision support tool for chronic pain treatment in primary care.
This study evaluates a prototype decision support tool to aid primary care clinicians when caring for patients with chronic noncancer pain called The Chronic Pain Treatment Tracker (Tx Tracker). The authors conducted 12 semi-structured interviews with primary care clinicians from four Indiana health systems. The interviews were conducted in two waves, with the last 6 interviews prototype and interview guide revisions. The interviews explored the Tx Tracker using a think-aloud approach and a clinical scenario. Evaluation questions were also asked. The researchers identified several themes: the need for clinicians to be presented with a comprehensive patient history, the usefulness of Tx Tracker in patient discussions about treatment planning, potential usefulness of Tx Tracker for patients with high uncertainty or risk, potential usefulness of Tx Tracker in aggregating scattered information, variability in expectations about workflows, skepticism about underlying electronic health record data quality, interest in using Tx Tracker to annotate or update information, interest in using Tx Tracker to translate information to clinical action, desire for interface with visual cues for risks, warnings, or treatment options, and desire for interactive functionality.
AHRQ-funded; HS023306.
Citation:
Allen KS, Danielson EC, Downs SM .
Evaluating a prototype clinical decision support tool for chronic pain treatment in primary care.
Appl Clin Inform 2022 May;13(3):602-11. doi: 10.1055/s-0042-1749332..
Keywords:
Clinical Decision Support (CDS), Primary Care, Chronic Conditions, Health Information Technology (HIT)
Huang J, Graetz I, Millman A
Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit.
The goal of this study was to examine the association between patient characteristics and primary care telemedicine choice among integrated delivery system patients self-scheduling visits during the COVID-19 pandemic. Findings showed that patients of Black or Hispanic race/ethnicity, or living in low socioeconomic status or low internet access neighborhoods were less likely to schedule video visits. Also, patients 65 years or older, with prior video visit experience or mobile portal access, or visiting their own personal provider were more likely to schedule video visits. While video adoption was substantial in all patient groups examined, differences in telemedicine choice suggested the persistence of a digital divide.
AHRQ-funded; HS025189.
Citation:
Huang J, Graetz I, Millman A .
Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit.
JAMIA Open 2022 Apr;5(1):ooac002. doi: 10.1093/jamiaopen/ooac002..
Keywords:
COVID-19, Primary Care, Telehealth, Health Information Technology (HIT), Access to Care
Snyder C, Choi Y, Smith KC
Realist review of care models that include primary care for adult childhood cancer survivors.
The authors conducted a realist review to describe how models of care that include primary care and relevant resources could be effective for adult survivors of childhood cancer. The variables from this program theory found most consistently in the literature included oncology vs primary care specialty, survivor and provider knowledge, provider comfort treating childhood cancer survivors, communication and coordination between and among providers and survivors, and delivery/receipt of prevention and surveillance of late effects.
AHRQ-funded; 75Q80120D00003.
Citation:
Snyder C, Choi Y, Smith KC .
Realist review of care models that include primary care for adult childhood cancer survivors.
JNCI Cancer Spectr 2022 Mar 2;6(2). doi: 10.1093/jncics/pkac012..
Keywords:
Cancer, Primary Care, Primary Care: Models of Care
Richardson JE, Rasmussen LV, Dorr DA
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
This study’s goal was to characterize strategies that seven regional cooperatives participating in the EvidenceNOW initiative developed to generate and report electronic health record (EHR)-based electronic clinical quality measures (eCQMs) for quality improvement (QI) in small-to-medium-sized practices. Findings showed that cooperatives ultimately generated and reported eCQMs using hybrid strategies because they determined that neither EHRs alone nor centralized sources alone could operationalize eCQMs for QI. In order to attain this goal, cooperatives needed to devise solutions and utilize resources that often are unavailable to typical small-to-medium-sized practices.
AHRQ-funded; HS023921.
Citation:
Richardson JE, Rasmussen LV, Dorr DA .
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
Appl Clin Inform 2022 Mar;13(2):485-94. doi: 10.1055/s-0042-1748145..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Quality of Care, Evidence-Based Practice, Primary Care
Perry CK, Linder S, Hall J
How type of practice ownership affects participation with quality improvement external facilitation: findings from EvidenceNOW.
This study examined how practice ownership influences participation in external facilitation using data from EvidenceNOW. The authors collected data from practices on practice characteristics and ownership type via surveys and from facilitators on the number of hours, encounters, and months each practice had with a facilitator via facilitation logs. Semi-structured interviewers with EvidenceNOW leadership (n = 12) and facilitators (n = 51) were conducted, and facilitators (n = 64) were observed for patterns of facilitation. In the fully adjusted model, differences by ownership were non-significant. Federally Qualified Health Centers (FQHCs) however, had significantly less participation in facilitation than clinician-owned practices for the measures number of encounters and number of months with encounters.
AHRQ-funded; HS023940.
Citation:
Perry CK, Linder S, Hall J .
How type of practice ownership affects participation with quality improvement external facilitation: findings from EvidenceNOW.
J Gen Intern Med 2022 Mar;37(4):793-801. doi: 10.1007/s11606-021-07204-7..
Keywords:
Quality Improvement, Quality of Care, Primary Care, Practice Improvement
Bierman AS, Tong ST, McNellis RJ
Realizing the dream: the future of primary care research.
In this article, the authors discussed the primary care research central to successful primary care transformation and to realizing the vision of a high-performing US health system to serve effectively all Americans and their communities while advancing health equity.
AHRQ-authored.
Citation:
Bierman AS, Tong ST, McNellis RJ .
Realizing the dream: the future of primary care research.
Ann Fam Med 2022 Mar-Apr;20(2):170-74. doi: 10.1370/afm.2788..
Keywords:
Primary Care, Healthcare Delivery, Evidence-Based Practice, Health Systems, Learning Health Systems, Patient-Centered Healthcare
Reese TJ, Schlechter CR, Kramer H
Implementing lung cancer screening in primary care: needs assessment and implementation strategy design.
This study explored the implementation of lung cancer screening with low-dose computed tomography (CT) in primary care. The study’s two goals included exploring the implementation of lung cancer screening primary care in the context of integrating a decision aid into the electronic health record and a designing of implementation strategies that target hypothesized mechanics of change and context-specific barriers. The two phases included a Qualitative Analysis phase including semi-structured interviews with primary care physicians to elicit key task behaviors, and an Implementation Strategy Design phase consisting of defining implementation strategies and hypothesizing causal pathways to improve screening with a decision aid. Fourteen interviews were conducted and out of that 3 key task behaviors and four behavioral determinants emerged. Strategies included increasing provider self-efficacy toward performing shared decision making and using the decision aid, improving provider performance expectancy, increasing social influence, and addressing key facilitators to using the decision aid.
AHRQ-funded; HS026198.
Citation:
Reese TJ, Schlechter CR, Kramer H .
Implementing lung cancer screening in primary care: needs assessment and implementation strategy design.
Transl Behav Med 2022 Feb 16;12(2):187-97. doi: 10.1093/tbm/ibab115..
Keywords:
Cancer: Lung Cancer, Cancer, Primary Care, Screening, Implementation, Decision Making
Schuttner L, Hockett Sherlock S, Simons C
Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study.
Researchers sought to describe factors affecting physician decision-making when care planning for complex patients with multimorbidity within the team-based, patient-centered medical home setting in the integrated healthcare system of the U.S. Department of Veterans Affairs, the Veterans Health Administration (VHA). They found that primary care physicians described internal, external, and relationship-based factors that affected their care planning for high-risk and complex patients with multimorbidity in the VHA.
AHRQ-funded; HS026369.
Citation:
Schuttner L, Hockett Sherlock S, Simons C .
Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study.
BMC Prim Care 2022 Feb 5;23(1):25. doi: 10.1186/s12875-022-01633-x..
Keywords:
Primary Care, Decision Making, Chronic Conditions, Patient-Centered Healthcare
Adler-Milstein J, Linden A, Bernstein S
Longitudinal participation in delivery and payment reform programs among US primary care organizations.
The purpose of this retrospective, observational study was to assess longitudinal primary care organization participation patterns in large-scale reform programs and to identify organizational characteristics associated with multiprogram participation. Medicare claims were used to identify organizations that delivered primary care services. Findings showed that no program achieved more than 50% participation; 36% of organizations did not participate in any program; 50% participated in one; 13% in two; and 1% in all three. Larger organizations, those with younger providers, those with more primary care providers, and those with larger Medicare patient panels were more likely to participate in more programs.
AHRQ-funded; HS025165.
Citation:
Adler-Milstein J, Linden A, Bernstein S .
Longitudinal participation in delivery and payment reform programs among US primary care organizations.
Health Serv Res 2022 Feb;57(1):47-55. doi: 10.1111/1475-6773.13646..
Keywords:
Primary Care, Medicare, Healthcare Delivery
Markovitz AA, Ryan AM, Peterson TA
ACO awareness and perceptions among specialists versus primary care physicians: a survey of a large Medicare Shared Savings program.
This research letter describes a survey that was conducted to compare accountable care organization (ACO) awareness and perceptions among specialists versus primary care physicians (PCPs). The survey was administered in 2018 to clinicians in the Physician Organization of Michigan ACO, which was the largest Medicare Shared Savings Program (MSSP) in Michigan and among the ten largest nationally at the time. The analysis focused on 1022 non-pediatrician physician respondents practicing within 10 provider organizations. Physician respondents included PCPs (23%) and specialists (77%). The most common specialty was internal medicine (20%), followed by surgeons (14%). Specialists were less likely to be aware of ACO participation and incentives. They were also 25% less likely to know they were in an ACO compared to PCPs. In addition, specialists were 18% less likely to know their ACO was accountable for both spending and quality or that their ACO had lowered spending in the previous year. This difference in perception may help to explain ACOs’ modest impact on spending and quality.
AHRQ-funded; HS025615.
Citation:
Markovitz AA, Ryan AM, Peterson TA .
ACO awareness and perceptions among specialists versus primary care physicians: a survey of a large Medicare Shared Savings program.
J Gen Intern Med 2022 Feb;37(2):492-94. doi: 10.1007/s11606-020-06556-w..
Keywords:
Primary Care, Healthcare Costs, Medicare, Provider: Physician
Burstein DS, Liss DT, Linder JA
Association of primary care physician compensation incentives and quality of care in the United States, 2012-2016.
AHRQ-funded; 233201500020I; HS026506; HS028127.
Citation:
Burstein DS, Liss DT, Linder JA .
Association of primary care physician compensation incentives and quality of care in the United States, 2012-2016.
J Gen Intern Med 2022 Feb;37(2):359-66. doi: 10.1007/s11606-021-06617-8..
Keywords:
Primary Care, Payment, Quality of Care
