Do interventions promoting medical homes in FQHCs improve continuity of care for Medicare beneficiaries?

Christine Buttorff, Justin W. Timbie, Tara A. Lavelle, Rosalie Malsberger, Amii M. Kress, Claude M. Setodji, Katherine L. Kahn

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Aims: We examine whether primary care continuity of care (PCCOC) improved for Medicare beneficiaries under a 3-year demonstration to help federally qualified health centers (FQHCs) become patient-centered medical homes (PCMH). Subjects and methods: We used a difference-in-differences analysis to compare changes over time in PCCOC for beneficiaries in 503 demonstration sites to those in 827 comparison sites. We measured PCCOC using the claims-based usual provider of care (UPC) index (range 0–1) indicating the proportion of visits to the most commonly seen provider or practice over a 1-year period. Results: Average baseline UPC index values were 0.77 at the provider level and 0.88 at the practice level, with similar values for demonstration and comparison sites. UPC decreased more over time in demonstration clinics than comparison clinics, but the magnitude of these changes were small. Conclusions: FQHCs already have high levels of PCCOC. These levels did not increase in association with the 3-year PCMH demonstration. Continuity for practices is higher than for providers, suggesting that Medicare beneficiaries may see multiple providers within one FQHC.

Original languageEnglish (US)
Pages (from-to)255-267
Number of pages13
JournalJournal of Public Health (Germany)
Issue number2
StatePublished - Apr 2021


  • Continuity of care
  • Dual-eligible
  • Federally qualified health center
  • Medical home
  • Medicare
  • Medicare beneficiaries
  • Patient-centered medical home

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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