Access Intervention in an Integrated, Prepaid Group Practice: Effects on Primary Care Physician Productivity
Open accessAbstract
Objective. To estimate the joint effect of a multifaceted access intervention on primary care physician (PCP) productivity in a large, integrated prepaid group practice. Data Sources. Administrative records of physician characteristics, compensation and full‐time equivalent (FTE) data, linked to enrollee utilization and cost information. Study Design. Dependent measures per quarter per FTE were office visits, work relative value units (WRVUs), WRVUs per visit, panel size, and total cost per member per quarter (PMPQ), for PCPs employed >0.25 FTE. General estimating equation regression models were included provider and enrollee characteristics. Principal Findings. Panel size and RVUs per visit rose, while visits per FTE and PMPQ cost declined significantly between baseline and full implementation. Panel size rose and visits per FTE declined from baseline through rollout and full implementation. RVUs per visit and RVUs per FTE first declined, and then increased, for a significant net increase of RVUs per visit and an insignificant rise in RVUs per FTE between baseline and full implementation. PMPQ cost rose between baseline and rollout and then declined, for a significant overall decline between baseline and full implementation. Conclusions. This organization‐wide access intervention was associated with improvements in several dimensions in PCP productivity and gains in clinical efficiency.
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In a 2008 Group Health Cooperative study, findings indicate a significant decline in cost between baseline and full implementation resulting from gains in productivity and clinical efficiency.
“The findings indicate a significant decline in cost between baseline and full implementation resulting from gains in productivity and clinical efficiency.”
From The Empirical Foundations of Telemedicine Interventions in Primary Care (2016) · cites this paper as [129]
The Abstract reports a significant decline in per-member-per-quarter cost between baseline and full implementation, alongside improvements in productivity and clinical efficiency. The Conclusions caution that, without a comparable control group, the study cannot infer direct causal effects; the claim's assertion that the cost decline resulted from those gains overstates the evidence. (LLM, conf=0.88)
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References 23 · Cited by 16
- Authors
- Conrad, D., Fishman, P., Grembowski, D., Ralston, J., Reid, R., Martin, D., Larson, E., & Anderson, M.
- Affiliations
- University of Washington (US)
- Group Health Cooperative (US)
- Corresponding author
- Conrad, Douglas
- ORCID
- Venue
- Health Services Research
- Publisher
- Wiley
- Published
- 2008-09-20
- Volume
- 43
- Issue
- 5p2
- Pages
- 1888-1905
- ISSN
- 0017-9124 (ISSN-L)
- 1475-6773
- PMC
- PMC2654163
- OpenAlex
- W2009188945
- Semantic Scholar
- e98bbe6593eb9adc9cb92b675ba5bc8d3d12d64b
- Cited by
- 16
- References
- 23
- Citations by year
- 2022: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2016: 2 · 2015: 1 · 2012: 2
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Health Services Research (publishedVersion, other-oa)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Robert Wood Johnson Foundation
- University of Washington
- Topics
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Keywords
- prepaid group practice, integrated care, panel size, relative value units, clinical efficiency, physician remuneration, office visits
- MeSH terms
- Ambulatory Care Information Systems, Diagnosis-Related Groups, Efficiency, Female, Group Practice, Prepaid, Health Maintenance Organizations, Health Services Accessibility, Health Services Research, Humans, Idaho, Male, Motivation, Office Visits, Physicians, Family, Primary Health Care, Regression Analysis, Washington, Program Evaluation, Relative Value Scales, Models, Organizational, Patient-Centered Care, Delivery of Health Care, Integrated, Internet
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