TY - JOUR
T1 - Chronic care improvement in primary care
T2 - Evaluation of an integrated pay-for-performance and practice-based care coordination program among elderly patients with diabetes
AU - Fagan, Peter J.
AU - Schuster, Alyson B.
AU - Boyd, Cynthia
AU - Marsteller, Jill A.
AU - Griswold, Michael
AU - Murphy, Shannon M.E.
AU - Dunbar, Linda
AU - Forrest, Christopher B.
PY - 2010/12
Y1 - 2010/12
N2 - Objective. To examine the effects of an intervention comprising (1) a practice-based care coordination program, (2) augmented by pay for performance (P4P) for meeting quality targets, and (3) complemented by a third-party disease management on quality of care and resource use for older adults with diabetes. Data Sources/Study Setting. Claims files of a managed care organization (MCO) for 20,943 adults aged 65 and older with diabetes receiving care in Alabama, Tennessee, or Texas, from January 2004 to March 2007. Study Design. A quasi-experimental, longitudinal study in which pre- and postdata from 1,587 patients in nine intervention primary care practices were evaluated against 19,356 patients in MCO comparison practices (>900). Five incentivized quality measures, two nonincentivized measures, and two resource-use measures were investigated. We examined trends and changes in trends from baseline to follow-up, contrasting intervention and comparison group member results. Principal Findings. Quality of care generally improved for both groups during the study period. Only slight differences were seen between the intervention and comparison group trends and changes in trends over time. Conclusions. This study did not generate evidence supporting a beneficial effect of an on-site care coordination intervention augmented by P4P and complemented by third-party disease management on diabetes quality or resource use.
AB - Objective. To examine the effects of an intervention comprising (1) a practice-based care coordination program, (2) augmented by pay for performance (P4P) for meeting quality targets, and (3) complemented by a third-party disease management on quality of care and resource use for older adults with diabetes. Data Sources/Study Setting. Claims files of a managed care organization (MCO) for 20,943 adults aged 65 and older with diabetes receiving care in Alabama, Tennessee, or Texas, from January 2004 to March 2007. Study Design. A quasi-experimental, longitudinal study in which pre- and postdata from 1,587 patients in nine intervention primary care practices were evaluated against 19,356 patients in MCO comparison practices (>900). Five incentivized quality measures, two nonincentivized measures, and two resource-use measures were investigated. We examined trends and changes in trends from baseline to follow-up, contrasting intervention and comparison group member results. Principal Findings. Quality of care generally improved for both groups during the study period. Only slight differences were seen between the intervention and comparison group trends and changes in trends over time. Conclusions. This study did not generate evidence supporting a beneficial effect of an on-site care coordination intervention augmented by P4P and complemented by third-party disease management on diabetes quality or resource use.
KW - Pay for performance
KW - care management
KW - evaluation design
KW - longitudinal study
KW - outcomes measurement
KW - primary care
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U2 - 10.1111/j.1475-6773.2010.01166.x
DO - 10.1111/j.1475-6773.2010.01166.x
M3 - Article
C2 - 20849553
AN - SCOPUS:78449274258
SN - 0017-9124
VL - 45
SP - 1763
EP - 1782
JO - Health services research
JF - Health services research
IS - 6 PART 1
ER -