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Home Research Research Library More Comprehensive Care Among Family Physicians is Associated with Lower Costs and Fewer Hospitalizations More Comprehensive Care Among Family Physicians is Associated with Lower Costs and Fewer Hospitalizations 2015 Author(s) Bazemore, Andrew W, Petterson, Stephen M, Peterson, Lars E, and Phillips, Robert L Topic(s) Role of Primary Care, Achieving Health System Goals, and What Family Physicians Do Keyword(s) Cost Of Care, and Quality Of Care Volume Annals of Family Medicine Source Annals of Family Medicine PURPOSE: Comprehensiveness is lauded as 1 of the 5 core virtues of primary care, but its relationship with outcomes is unclear. We measured associations between variations in comprehensiveness of practice among family physicians and healthcare utilization and costs for their Medicare beneficiaries. METHODS: We merged data from 2011 Medicare Part A and B claims files for a complex random sample of family physicians engaged in direct patient care, including 100% of their claimed care of Medicare beneficiaries, with data reported by the same physicians during their participation in Maintenance of Certification for Family Physicians (MC-FP) between the years 2007 and 2011. We created a measure of comprehensiveness from mandatory self-reported survey items as part of MC-FP examination registration. We compared this measure to another derived from Medicare’s Berenson-Eggers Type of Service (BETOS) codes. We then examined the association between the 2 measures of comprehensiveness and hospitalizations, Part B payments, and combined Part A and B payments. RESULTS: Our full family physician sample consists of 3,652 physicians providing the plurality of care to 555,165 Medicare beneficiaries. Of these, 1,133 recertified between 2007 and 2011 and cared for 185,044 beneficiaries. There was a modest correlation (0.30) between the BETOS and self-reported comprehensiveness measures. After adjusting for beneficiary and physician characteristics, increasing comprehensiveness was associated with lower total Medicare Part A and B costs and Part B costs alone, but not with hospitalizations; the association with spending was stronger for the BETOS measure than for the self-reported measure; higher BETOS scores significantly reduced the likelihood of a hospitalization. CONCLUSIONS: Increasing family physician comprehensiveness of care, especially as measured by claims measures, is associated with decreasing Medicare costs and hospitalizations. Payment and practice policies that enhance primary care comprehensiveness may help “bend the cost curve.” Read More ABFM Research Read all 2016 “Community vital signs”: incorporating geocoded social determinants into electronic records to promote patient and population health Go to “Community vital signs”: incorporating geocoded social determinants into electronic records to promote patient and population health 2018 Response: Re: Burnout in Young Family Physicians: Variation Across States Go to Response: Re: Burnout in Young Family Physicians: Variation Across States 2013 Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery Go to Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery 2014 Electronic health record functionality needed to better support primary care Go to Electronic health record functionality needed to better support primary care
Author(s) Bazemore, Andrew W, Petterson, Stephen M, Peterson, Lars E, and Phillips, Robert L Topic(s) Role of Primary Care, Achieving Health System Goals, and What Family Physicians Do Keyword(s) Cost Of Care, and Quality Of Care Volume Annals of Family Medicine Source Annals of Family Medicine
ABFM Research Read all 2016 “Community vital signs”: incorporating geocoded social determinants into electronic records to promote patient and population health Go to “Community vital signs”: incorporating geocoded social determinants into electronic records to promote patient and population health 2018 Response: Re: Burnout in Young Family Physicians: Variation Across States Go to Response: Re: Burnout in Young Family Physicians: Variation Across States 2013 Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery Go to Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery 2014 Electronic health record functionality needed to better support primary care Go to Electronic health record functionality needed to better support primary care
2016 “Community vital signs”: incorporating geocoded social determinants into electronic records to promote patient and population health Go to “Community vital signs”: incorporating geocoded social determinants into electronic records to promote patient and population health
2018 Response: Re: Burnout in Young Family Physicians: Variation Across States Go to Response: Re: Burnout in Young Family Physicians: Variation Across States
2013 Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery Go to Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery
2014 Electronic health record functionality needed to better support primary care Go to Electronic health record functionality needed to better support primary care
