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

Date: July 21, 2019
Journal: Journal of Public Health
Citation: Buttorff C, Timbie JW, Lavelle TA, Malsberger R, Kress AM, Setodji CM, Kahn KL . Do interventions promoting medical homes in FQHCs improve continuity of care for Medicare beneficiaries? Journal of Public Health 2019;:1–13.

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.

More Publications