Evaluating community health centers' adoption of a new global capitation payment (eCHANGE) study protocol

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• 作者：H Angier ; MPH^a ; ^{angierh@ohsu.edu} ; JP O'Malley ; MPH^a ; M Marino ; PhD^a ; KJ McConnell ; PhD^a ; E Cottrell ; PhD^a ; ^b ; RL Jacob ; ScM^b ; S Likumahuwa-Ackman ; MID ; MPH^a ; J Heintzman ; MD ; MPH^a ; N Huguet ; PhD^a ; SR Bailey ; PhD^a ; JE DeVoe ; MD ; PhD^a ; ^b
• 关键词：APM ; Alternative Payment Methodology ; CCO ; coordinated care organization ; CHC ; community health center ; EHR ; electronic health record ; FFS ; fee-for-service ; FQHC ; federally-qualified health center ; GLMM ; generalized linear mixed model ; PBRN ; practice-based research network ; PCMH ; primary care medical home ; PMPM ; per-member-per-month ; OHA ; Oregon Health Authority ; RHC ; rural health center
• 刊名：Contemporary Clinical Trials
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：52
• 期：Complete
• 页码：35-38
• 全文大小：213 K
• 卷排序：52

文摘

Primary care patient-centered medical homes (PCMHs) are an effective healthcare delivery model. Evidence regarding the most effective payment models for increased coordination efforts is sparse. This protocol paper describes the evaluation of an Alternative Payment Methodology (APM) implemented in a subset of Oregon community health centers (CHCs), using a prospective matched observational design. The APM is a primary care payment reform intervention that changed Oregon's Medicaid payment for several CHCs from fee-for-service reimbursement to a per-member-per-month capitated payment. We will implement a difference-in-difference analytic approach to evaluate pre-post APM changes between intervention and control groups, including: 1) clinic-level outcomes, 2) patient-level clinical outcomes, and 3) patient-level econometric outcomes. Findings from the project will be of national significance, as there is a need for evidence regarding how novel payment methods might enhance PCMH capabilities and support their capacity to produce better quality and outcomes. If this capitated payment method is proven effective, study findings will inform dissemination of similar APMs nationwide.