Evaluation of the Comprehensive Primary Care Initiative (CPC)
2019年8月12日 更新者:Randy Brown、Mathematica Policy Research, Inc.
This study assesses the effects of the Centers for Medicare and Medicaid Services' Comprehensive Primary Care (CPC) initiative on physician practices, practice staff, Medicare and Medicaid costs and service utilization, quality of care, and patient outcomes.
CPC provides financial resources, timely feedback on key practice outcomes, and a learning network to support practice transformation to improve quality of care and lower costs.
研究概览
地位
完全的
详细说明
CMS selected 7 regions (states or substate areas) to include in this study, based on commitment of other (ie, nonMedicare) payers in the area to provide financial resources to participating practices to support practice transformation to improve quality of care, reduce costs, and improve population health.
497 practices were selected from roughly 1000 applicants in the 7 regions to participate in the study.
CMS pays participating practices a per member per month care management fee for each Medicare patient attributed to the practice.
The practices also receive quarterly feedback on trends in their Medicare patients' use of hospital and emergency room services, Medicare expenditures, and patient outcomes from periodic surveys.
Practices are expected to improve patient outcomes and lower Medicare costs per patient by using the additional resources to improve: risk-stratified care management, access and continuity of care, planned chronic and preventive care, patient and caregiver engagement, and coordination across the medical neighborhood.
To remain in the study, practices must meet annual milestones for meaningful use of electronic health records and other practice features.
The intervention period, which began in Fall 2012, will continue for 4 years.
研究类型
介入性
注册 (实际的)
365076
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习地点
-
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New Jersey
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Princeton、New Jersey、美国、08540
- Mathematica Policy Research
-
-
参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
21年 及以上 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- Medicare beneficiary attributed to CPC practice or to a matched comparison practice. Patients are attributed to the practice from which they received the most E&M visits during the 2-year period examined.
Exclusion Criteria:
- Beneficiaries enrolled in a managed care plan.
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:卫生服务研究
- 分配:非随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
实验性的:Treatment group
Practices assigned to the treatment group received per member per month care management fees for each Medicare beneficiary attributed to their practice.
They also received quarterly feedback reports on their patients' average Medicare expenditures and use of hospital and emergency room services.
Practices also had access to regional learning faculties for technical assistance with transformation activities and to share lessons across practices.
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for each Medicare beneficiary attributed to the practice, the practice received a monthly care management fee
Each participating practice received quarterly reports showing the practice's trend in key outcomes during the pre-intervention and intervention periods.
The risk adjusted average Medicare expenditures of their patients were also shown in relation to all of the other CPC practices in their region, and to those with a similar average risk profile.
Unadjusted hospitalization rates and emergency room visits were also plotted over time and compared to those of other CPC practices in the region
CPC practices could ask for technical assistance on transformation activities from a regional learning faculty (RLF).
The RLF also provided seminars and other learning activities, as well as provided a forum for participating practices to share lessons they had learned.
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无干预:Comparison group
Within each of the 7 regions, this group is comprised of practices that were matched to the treatment practices on a wide range of baseline characteristics of the practices (including their service utilization patterns) and their patients.
Comparison practices were selected from a pool of practices including those that applied to participate but were not selected, and practices serving nearby external comparison areas.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Medicare expenditures
大体时间:12 months
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average Medicare expenditures per month in Medicare fee-for-service
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12 months
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
number of ER visits
大体时间:12 months
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number of emergency room visits that did not result in a hospital admission
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12 months
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number of hospital admissions
大体时间:12 months
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number of admissions to general acute short term hospitals during the followup period
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12 months
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30-day hospital readmission rate
大体时间:30-days
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whether readmitted to the hospital within 30 days after discharge
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30-days
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hospital admission for ambulatory care sensitive condition
大体时间:12 months
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whether admitted to hospital for a condition classified as being sensitive to the quality of ambulatory care received
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12 months
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员:deborah peikes, PhD、Mathematica Policy Research
- 研究主任:Timothy Day, MPP、Centers for Medicare & Medicaid Services
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Peikes DN, Swankoski K, Hoag SD, Duda N, Coopersmith J, Taylor EF, Morrisson N, Palakal M, Holland J, Day TJ, Sessums LL. The Effects of a Primary Care Transformation Initiative on Primary Care Physician Burnout and Workplace Experience. J Gen Intern Med. 2019 Jan;34(1):49-57. doi: 10.1007/s11606-018-4545-0. Epub 2018 Jul 17.
- Dale SB, Ghosh A, Peikes DN, Day TJ, Yoon FB, Taylor EF, Swankoski K, O'Malley AS, Conway PH, Rajkumar R, Press MJ, Sessums L, Brown R. Two-Year Costs and Quality in the Comprehensive Primary Care Initiative. N Engl J Med. 2016 Jun 16;374(24):2345-56. doi: 10.1056/NEJMsa1414953. Epub 2016 Apr 13.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2012年7月1日
初级完成 (实际的)
2017年7月1日
研究完成 (实际的)
2018年5月1日
研究注册日期
首次提交
2014年12月15日
首先提交符合 QC 标准的
2014年12月18日
首次发布 (估计)
2014年12月19日
研究记录更新
最后更新发布 (实际的)
2019年8月14日
上次提交的符合 QC 标准的更新
2019年8月12日
最后验证
2019年8月1日
更多信息
与本研究相关的术语
其他研究编号
- HHSM-500-T0006
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
不
IPD 计划说明
not allowed; data belong to federal government (CMS)
药物和器械信息、研究文件
研究美国 FDA 监管的药品
不
研究美国 FDA 监管的设备产品
不
在美国制造并从美国出口的产品
不
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
care management fee的临床试验
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Washington University School of MedicineNational Institute of Mental Health (NIMH)招聘中
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George Washington UniversityTranscultural Psychosocial Organization Nepal完全的
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Copenhagen University Hospital at HerlevRigshospitalet, Denmark未知
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University Health Network, Toronto招聘中淋巴瘤 | 淋巴增生性疾病 | 乳腺癌一期 | 乳腺癌二期 | 结直肠癌 II 期 | 结直肠癌 III 期 | 乳腺癌三期 | 结直肠癌 I 期 | 头颈癌 III 期 | 乳腺癌,0 期 | 头颈癌 I 期 | 头颈癌 II 期加拿大