@article{22cbac6eea024efaba39022eb55d0753,
title = "Do interventions promoting medical homes in FQHCs improve continuity of care for Medicare beneficiaries?",
abstract = "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.",
keywords = "Continuity of care, Dual-eligible, Federally qualified health center, Medical home, Medicare, Medicare beneficiaries, Patient-centered medical home",
author = "Christine Buttorff and Timbie, {Justin W.} and Lavelle, {Tara A.} and Rosalie Malsberger and Kress, {Amii M.} and Setodji, {Claude M.} and Kahn, {Katherine L.}",
note = "Funding Information: Funding support: funding was provided by Centers for Medicare & Medicaid Services, (Contract: HHSM-500-2005-00028I, Task # T0008). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. Funding Information: Affordable Care Act (ACA) grantee is an indicator that the site received ACA Building Capacity, New Access Point and/or Immediate Facility Improvement grants (CSSP 2011 ). Health Center Controlled Network (HCCN). grantee indicates whether the site received funding from HRSA to facilitate health IT collaborations between health centers (HRSA 2017a ). Quality accreditation indicates whether the site received accreditation from the National Committee for Quality Assurance (NCQA), the Joint Commission, or the Accreditation Association for Ambulatory Care (HRSA 2018 ). CMS shared savings program participation indicates whether the site was participating in either the Pioneer Accountable Care Organization program or the Medicare Shared Savings Program (CMMI 2018 ). Patient-centered medical home (PCMH) supplemental funding is an indicator for whether a site received a one-time grant for facilitating PCMH practice transformation in 2011 (AAAHC 2011 ). The HRSA PCMH initiative is an indicator of whether the site received support from HRSA to cover the cost of applying for PCMH recognition. Publisher Copyright: {\textcopyright} 2019, Springer-Verlag GmbH Germany, part of Springer Nature.",
year = "2021",
month = apr,
doi = "10.1007/s10389-019-01090-4",
language = "English (US)",
volume = "29",
pages = "255--267",
journal = "Journal of Public Health (Germany)",
issn = "2198-1833",
publisher = "Springer Verlag",
number = "2",
}