QUiC Clinics in the Central Texas Market: Value-Based Primary Care in Military Medicine
| Autor: | Brian J Flannery, Garrett Meyers, Richard Malish, Brian T Hall |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
021110 strategic
defence & security studies computer.internet_protocol 0211 other engineering and technologies Public Health Environmental and Occupational Health QUIC 02 engineering and technology General Medicine Healthcare Effectiveness Data and Information Set medicine.disease Military medicine 03 medical and health sciences 0302 clinical medicine Patient satisfaction Incentive Phone Patient experience medicine 030212 general & internal medicine Business Medical emergency Market value computer |
| Zdroj: | Military medicine. 188(1-2) |
| ISSN: | 1930-613X |
| Popis: | Introduction For the past 16 years, Military Health System primary care providers have been incentivized to pursue work in a fee-for-service (FFS) model. The system values documentation of productivity to earn as many relative value units as possible. The result is densely packed clinic schedules that often lack the space or flexibility to accommodate patients when sick. Leakage ensues. Furthermore, prevention and patient experience are not directly incentivized. Methods The Central Texas Market’s Accountable Care Organization reformed incentives in its #5 FFS-designed community-based medical homes to value outcomes over productivity. The resulting quality, urgent, internet, and phone care (QUiC) clinics are value-based and, therefore, better structured to achieve the Quad aim (better care, better health/readiness, and low cost). Forsaking deeply ingrained FFS practices, QUiC clinics funnel all routine (information-sharing) appointments into efficient internet or phone appointments. With the time freed by managing common needs in short bursts, QUiC clinics see sick patients with no notice (urgent care). They also focus on prevention and patient experience. We measured the effectiveness of the QUiC clinics in the value-based metrics of (1) patient experience, (2) Healthcare Effectiveness Data and Information Set measures of quality and prevention. (3) access-to-care, (4) leakage, and (5) enrollment. Results Over a 19 month period, the five community-based medical homes improved significantly in all areas. Specifically, measures of patient satisfaction improved from the mid-80s percent satisfied to the mid-90s percent satisfied. Healthcare Effectiveness Data and Information Set measures increased from average compared to national benchmarks ( Conclusions This performance improvement project proved the concept that a military market can vastly improve value-based primary care outcomes at no cost and within multiple community-based clinics. |
| Databáze: | OpenAIRE |
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