Chronic Diseases Clinical Trial
— eCHANGEOfficial title:
Evaluating Community Health Centers' Adoption of a New Global Capitation Payment
Verified date | October 2019 |
Source | Oregon Health and Science University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
The investigators are conducting a prospective analysis of the Alternative Payment Methodology (APM) demonstration project sites. The investigators' goal is to conduct a cross project analysis of findings. The investigators propose to use mixed methods to study processes and outcomes associated with the APM natural experiment in payment reform. The investigators hypothesize that Community Health Centers (CHCs) participating in the APM demonstration project will redesign their workflows to better focus on patient and population health needs, resulting in reallocation of financial resources, lower overall costs, changes in utilization patterns, and improved quality.
Status | Active, not recruiting |
Enrollment | 400000 |
Est. completion date | May 2020 |
Est. primary completion date | May 2020 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 2 Years to 64 Years |
Eligibility |
Inclusion Criteria: 1. Total clinic population: established patients at intervention and control clinics aged 2-64 2. Medicaid Population: Medicaid-enrolled patients at intervention and control clinics aged 2-64 Exclusion Criteria: 1. Total clinic population: non-established patients at intervention and control clinics aged 2-64 2. Medicaid Population: non-Medicaid-enrolled patients at intervention and control clinics aged 2-64 |
Country | Name | City | State |
---|---|---|---|
n/a |
Lead Sponsor | Collaborator |
---|---|
Oregon Health and Science University | Agency for Healthcare Research and Quality (AHRQ), Ochin, Inc., Robert Wood Johnson Foundation |
Angier H, O'Malley JP, Marino M, McConnell KJ, Cottrell E, Jacob RL, Likumahuwa-Ackman S, Heintzman J, Huguet N, Bailey SR, DeVoe JE. Evaluating community health centers' adoption of a new global capitation payment (eCHANGE) study protocol. Contemp Clin T — View Citation
Cottrell EK, Hall JD, Kautz G, Angier H, Likumahuwa-Ackman S, Sisulak L, Keller S, Cameron DC, DeVoe JE, Cohen DJ. Reporting From the Front Lines: Implementing Oregon's Alternative Payment Methodology in Federally Qualified Health Centers. J Ambul Care Ma — View Citation
Heintzman J, Cottrell E, Angier H, O'Malley J, Bailey S, Jacob L, DeVoe J, Ukhanova M, Thayer E, Marino M. Impact of Alternative Payment Methodology on Primary Care Visits and Scheduling. J Am Board Fam Med. 2019 Jul-Aug;32(4):539-549. doi: 10.3122/jabfm.2019.04.180368. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Study the change processes associated with APM implementation | Qualitative assessment of practice change through interviews and site visits | =3 years pre-APM implementation and =3 years post | |
Primary | Internal services utilization | Number and type of internal services utilized including number and ratio of "traditional" face to face visits vs. "nontraditional" encounters and communication via phone, personal health record, and email | =3 years pre-APM implementation and =3 years post | |
Secondary | Quality care measures | We selected measures that are: 1) identified by Oregon's Medicaid program and/or those on the list of Clinical Quality Measures in the electronic health record (EHR) incentive programs; 2) feasibly measured with EHR or Medicaid claims data; 3) representative across age groups and gender; 4) representative of treatment levels (e.g., prevention, acute and chronic condition care); and 5) relevant to CHC populations. | =3 years pre-APM implementation and =3 years post | |
Secondary | External services utilization | Number and type of external services utilized including percent of patients with a follow-up appointment after discharge and average wait time | =3 years pre-APM implementation and =3 years post | |
Secondary | Medicaid expenditures | We will calculate the average pre-post APM difference in total Medicaid expenditures attributable to the subpopulation of Medicaid-insured patients in APM intervention clinics, subtracted by the average difference among Medicaid-insured patients in comparison clinics | =3 years pre-APM implementation and =3 years post |
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