Evaluating Community Health Centers' Adoption of a New Global Capitation Payment

NCT02637869 | Unknown

• 2 other identifiers: AHRQ R01HS2265171125
• Study Type: observational
• Target: 400,000
• Locations: 0 countries
• Sites: N/A

Brief Summary

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.

Conditions

Chronic Diseases

Keywords

Health Expenditures; Prospective Payment System; Health Care Utilization; Health Care Quality, Access, and Evaluation

Outcome Measures

Primary Outcomes (1)

• 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 Outcomes (3)

• Quality care measures

  ≤3 years pre-APM implementation and ≤3 years post

• External services utilization

  ≤3 years pre-APM implementation and ≤3 years post

• Medicaid expenditures

  ≤3 years pre-APM implementation and ≤3 years post

Other Outcomes (1)

• Study the change processes associated with APM implementation

  ≤3 years pre-APM implementation and ≤3 years post

Study Arms (2)

Control Group - non-intervention

Clinics that did not participate in the APM project

Alternative Payment Model -intervention

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

Other: Alternative Payment Model

Interventions

Alternative Payment Model OTHER

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

Alternative Payment Model -intervention

Eligibility Criteria

• Age: 2 Years - 64 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Community Health Center (CHC) and clinic patients of which CHCs are participating in the APM demonstration (intervention) or are matched with APM CHCs (control)

You may qualify if:

• Total clinic population:
• established patients at intervention and control clinics aged 2-64
• Medicaid Population:
• Medicaid-enrolled patients at intervention and control clinics aged 2-64

You may not qualify if:

• Total clinic population:
• non-established patients at intervention and control clinics aged 2-64
• Medicaid Population:
• non-Medicaid-enrolled patients at intervention and control clinics aged 2-64

Sponsors & Collaborators

• Oregon Health and Science University: lead
• OCHIN, Inc.: collaborator
• Robert Wood Johnson Foundation: collaborator
• Agency for Healthcare Research and Quality (AHRQ): collaborator

Related Publications (3)

• 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.

  PMID: 31300574 BACKGROUND

• 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 Trials. 2017 Jan;52:35-38. doi: 10.1016/j.cct.2016.11.001. Epub 2016 Nov 9.

  PMID: 27836506 RESULT

• 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 Manage. 2017 Oct/Dec;40(4):339-346. doi: 10.1097/JAC.0000000000000198.

  PMID: 28857887 RESULT

MeSH Terms

Conditions

Chronic Disease; Patient Acceptance of Health Care

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Officials

• John Heintzman, MD, MPH

  Oregon Health and Science University

  PRINCIPAL INVESTIGATOR

• Heather Angier, MPH

  Oregon Health and Science University

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: December 2, 2015
• First Posted: December 22, 2015
• Study Start: July 1, 2015
• Primary Completion: May 1, 2020
• Study Completion: May 1, 2020
• Last Updated: October 14, 2019

Record last verified: 2019-10