Evidence map›Paper›PMID 28720627›Full record

ArticleJournal of the American Board of Family Medicine : JABFM

Costs of Transforming Established Primary Care Practices to Patient-Centered Medical Homes (PCMHs).

Neil S Fleming, Briget da Graca, Gerald O Ogola, Steven D Culler, Jessica Austin, Patrice McConnell, Russell McCorkle, Phil Aponte, Michael Massey, Cliff Fullerton

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Neil S FlemingFrom the Center for Clinical Effectiveness (NSF, BdG, GOO) and STEEEP Analytics (JA), Office of the CQO, Baylor Scott & White Health, Dallas, TX; the Robbins Institute for Health Policy & Leadership, Baylor University, Waco (NSF, BdG); the Rollins School of Public Health, Emory University, Atlanta, GA (SDC); the HealthTexas Provider Network, Dallas (PM, RM, PA, MM); the Baylor Scott & White Quality Alliance, Dallas (MM, CF); and Baylor Scott & White Health, Dallas (CF). neil.fleming@baylorhealth.edu.
Briget da GracaFrom the Center for Clinical Effectiveness (NSF, BdG, GOO) and STEEEP Analytics (JA), Office of the CQO, Baylor Scott & White Health, Dallas, TX; the Robbins Institute for Health Policy & Leadership, Baylor University, Waco (NSF, BdG); the Rollins School of Public Health, Emory University, Atlanta, GA (SDC); the HealthTexas Provider Network, Dallas (PM, RM, PA, MM); the Baylor Scott & White Quality Alliance, Dallas (MM, CF); and Baylor Scott & White Health, Dallas (CF).
Gerald O OgolaFrom the Center for Clinical Effectiveness (NSF, BdG, GOO) and STEEEP Analytics (JA), Office of the CQO, Baylor Scott & White Health, Dallas, TX; the Robbins Institute for Health Policy & Leadership, Baylor University, Waco (NSF, BdG); the Rollins School of Public Health, Emory University, Atlanta, GA (SDC); the HealthTexas Provider Network, Dallas (PM, RM, PA, MM); the Baylor Scott & White Quality Alliance, Dallas (MM, CF); and Baylor Scott & White Health, Dallas (CF).
Steven D CullerFrom the Center for Clinical Effectiveness (NSF, BdG, GOO) and STEEEP Analytics (JA), Office of the CQO, Baylor Scott & White Health, Dallas, TX; the Robbins Institute for Health Policy & Leadership, Baylor University, Waco (NSF, BdG); the Rollins School of Public Health, Emory University, Atlanta, GA (SDC); the HealthTexas Provider Network, Dallas (PM, RM, PA, MM); the Baylor Scott & White Quality Alliance, Dallas (MM, CF); and Baylor Scott & White Health, Dallas (CF).
Jessica AustinFrom the Center for Clinical Effectiveness (NSF, BdG, GOO) and STEEEP Analytics (JA), Office of the CQO, Baylor Scott & White Health, Dallas, TX; the Robbins Institute for Health Policy & Leadership, Baylor University, Waco (NSF, BdG); the Rollins School of Public Health, Emory University, Atlanta, GA (SDC); the HealthTexas Provider Network, Dallas (PM, RM, PA, MM); the Baylor Scott & White Quality Alliance, Dallas (MM, CF); and Baylor Scott & White Health, Dallas (CF).
Patrice McConnellFrom the Center for Clinical Effectiveness (NSF, BdG, GOO) and STEEEP Analytics (JA), Office of the CQO, Baylor Scott & White Health, Dallas, TX; the Robbins Institute for Health Policy & Leadership, Baylor University, Waco (NSF, BdG); the Rollins School of Public Health, Emory University, Atlanta, GA (SDC); the HealthTexas Provider Network, Dallas (PM, RM, PA, MM); the Baylor Scott & White Quality Alliance, Dallas (MM, CF); and Baylor Scott & White Health, Dallas (CF).
Russell McCorkleFrom the Center for Clinical Effectiveness (NSF, BdG, GOO) and STEEEP Analytics (JA), Office of the CQO, Baylor Scott & White Health, Dallas, TX; the Robbins Institute for Health Policy & Leadership, Baylor University, Waco (NSF, BdG); the Rollins School of Public Health, Emory University, Atlanta, GA (SDC); the HealthTexas Provider Network, Dallas (PM, RM, PA, MM); the Baylor Scott & White Quality Alliance, Dallas (MM, CF); and Baylor Scott & White Health, Dallas (CF).
Phil AponteFrom the Center for Clinical Effectiveness (NSF, BdG, GOO) and STEEEP Analytics (JA), Office of the CQO, Baylor Scott & White Health, Dallas, TX; the Robbins Institute for Health Policy & Leadership, Baylor University, Waco (NSF, BdG); the Rollins School of Public Health, Emory University, Atlanta, GA (SDC); the HealthTexas Provider Network, Dallas (PM, RM, PA, MM); the Baylor Scott & White Quality Alliance, Dallas (MM, CF); and Baylor Scott & White Health, Dallas (CF).
Michael MasseyFrom the Center for Clinical Effectiveness (NSF, BdG, GOO) and STEEEP Analytics (JA), Office of the CQO, Baylor Scott & White Health, Dallas, TX; the Robbins Institute for Health Policy & Leadership, Baylor University, Waco (NSF, BdG); the Rollins School of Public Health, Emory University, Atlanta, GA (SDC); the HealthTexas Provider Network, Dallas (PM, RM, PA, MM); the Baylor Scott & White Quality Alliance, Dallas (MM, CF); and Baylor Scott & White Health, Dallas (CF).
Cliff FullertonFrom the Center for Clinical Effectiveness (NSF, BdG, GOO) and STEEEP Analytics (JA), Office of the CQO, Baylor Scott & White Health, Dallas, TX; the Robbins Institute for Health Policy & Leadership, Baylor University, Waco (NSF, BdG); the Rollins School of Public Health, Emory University, Atlanta, GA (SDC); the HealthTexas Provider Network, Dallas (PM, RM, PA, MM); the Baylor Scott & White Quality Alliance, Dallas (MM, CF); and Baylor Scott & White Health, Dallas (CF).

Funding

Costs of Transforming Established Primary Care Practices to Patient-Centered MediR03HS022621 · AHRQ · BAYLOR RESEARCH INSTITUTE · PI FLEMING, NEIL STEWART · 2013 to 2013
$100k
AHRQ HHS R03 HS022621
6 · The paper itself

Abstract

backgroundThe patient-centered medical home (PCMH) shows promise for improving care and reducing costs. We sought to reduce the uncertainty regarding the time and cost of PCMH transformation by quantifying the direct costs of transforming 57 practices in a medical group to National Committee for Quality Assurance (NCQA)-recognized Level III PCMHs.

methodsWe conducted structured interviews with corporate leaders, and with physicians, practice administrators, and office managers from a representative sample of practices regarding time spent on PCMH transformation and NCQA application, and related purchases. We then developed and sent a survey to all primary care practices (practice-level response rate: initial recognition-44.6%, renewal-35.7%). Direct costs were estimated as time spent multiplied by average hourly wage for the relevant job category, plus observed expenditures.

resultsWe estimated HealthTexas' corporate costs for initial NCQA recognition (2010-2012) at $1,508,503; for renewal (2014-2016), $346,617; the Care Coordination resource costs an additional ongoing $390,790/year. A hypothetical 5-physician HealthTexas practice spent another estimated 239.5 hours ($10,669) obtaining, and 110.5 hours ($4,957) renewing, recognition.

conclusionCentralized PCMH support reduces the burden on practices; however, overall time and cost remains substantial, and should be weighed against the mixed evidence regarding PCMH's impact on quality and costs of care.

Indexed as

Patient-Centered CareQuality Assurance, Health CareHealth ExpendituresHealth PolicyIncentive ReimbursementMedical HomePatient-Centered CarePractice ManagementPrimary Health CareSurveys and Questionnaires

Identifiers

PMID28720627
PMCPMC5939952

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.