Assessing and increasing patient panel size in the public sector

Area of Science:

• Primary Care Medicine
• Health Services Research

Background:

• Panel management is crucial for primary care medical homes but challenging in safety net settings.
• Community clinics face difficulties accommodating all patients seeking care.

Purpose of the Study:

• To evaluate patient panel size adjustments in 7 primary care clinics serving over 25,000 active patients.
• To assess the impact of new policies on clinic capacity and provider full-time equivalents (FTEs).

Main Methods:

• Adjusted panel sizes for patient demographics, diagnoses, homelessness, and substance abuse.
• Established a minimum panel size of 1125 patients per primary care provider (FTE).
• Calculated target vs. attained panel sizes and analyzed changes over nine months.

Main Results:

• Providers reached 82% of the aggregate target panel size within nine months.
• Five clinics increased adjusted panel size per FTE by 2% to 23%.
• Clinics reducing new patient appointment barriers saw significant gains; some clinics with new providers experienced a drop in panel size per FTE.

Conclusions:

• Routine data generation and review are vital for increasing primary care clinic capacity.
• Data-driven policies, panel size standards, and team-based care interventions enhance capacity.
• Addressing barriers to care and optimizing appointment scheduling are key to effective panel management.