Chronic Diseases Clinical Trial
Official title:
Evaluating Community Health Centers' Adoption of a New Global Capitation Payment
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.
Led by the Oregon Primary Care Association, three community health center (CHC) organizations
in Oregon developed an Alternative Payment Methodology (APM). Under this APM pilot
participating CHCs will receive a prospective payment system (PPS) payment as a capitated
equivalent in a per-member-per-month rate for all of their Medicaid patients. Oregon CHC
organizations (several clinic sites) implemented Phase I of this demonstration project on
March 1, 2013; Phase II A was implemented on July 1, 2014; Phase II B on October 1, 2014; and
Phase III began July 1, 2015.
We are a prospective analysis of the APM project sites. We propose to use mixed methods to
study processes and outcomes associated with the APM natural experiment in payment reform. We
hypothesize that 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.
The study will include baseline qualitative data collection as clinics are transitioning to
the APM methodology. We will conduct 2 site visits to each intervention clinic to observe
practice changes that occurred post APM-implementation (first visit approximately 12-18
months post-APM implementation; second visit approximately 30-36 months post-APM
implementation). We will also assemble and analyze of pre-post quantitative and qualitative
datasets, and interpretation and dissemination of study findings.
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