New Approaches to Measuring the Comprehensiveness of Primary Care Physicians

Publisher: Health Services Research (online ahead of print)
Jan 06, 2019
Ann S. O'Malley, Eugene C. Rich, Lisa Shang, Tyler Rose, Arkadipta Ghosh, Dmitriy Poznyak, and Deborah Peikes

This Health Services Research study aimed to develop claims‐based measures of comprehensiveness of primary care physicians (PCPs) and summarize their associations with health care utilization and cost. Researchers developed Medicare claims‐based measures of physician comprehensiveness (involvement in patient conditions and new problem management) and used a previously developed range of services measure. They analyzed the association of PCPs’ comprehensiveness in 2013 with their beneficiaries’ emergency department, hospitalizations rates, and ambulatory care‐sensitive condition (ACSC) admissions (each per 1000 beneficiaries per year), and Medicare expenditures (per beneficiary per month) in 2014, adjusting for beneficiary, physician, practice, and market characteristics, and clustering. The study found the measures demonstrate strong content and predictive validity and reliability. In sum, Medicare beneficiaries of PCPs providing more comprehensive care had lower hospitalization rates, ED visits, and total Medicare expenditures.