Patient experience midway through a large primary care practice transformation initiative

Area of Science:

• Health Services Research
• Primary Care Transformation
• Patient-Centered Medical Home

Background:

• The Comprehensive Primary Care (CPC) initiative aimed to transform primary care delivery.
• Evaluating the impact of such initiatives on patient experience is crucial for healthcare improvement.
• Medicare fee-for-service beneficiaries are a key population for assessing primary care changes.

Purpose of the Study:

• To assess the effect of the multipayer Comprehensive Primary Care (CPC) initiative on patient experience.
• To compare changes in patient experience between CPC and comparison practices over time.
• To identify areas for further improvement in patient experience within primary care settings.

Main Methods:

• Prospective study with two serial cross-sectional samples of Medicare fee-for-service beneficiaries.
• Utilized the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician and Group Survey with Patient-Centered Medical Home supplemental items.
• Employed regression-adjusted difference-in-differences analysis to compare changes between CPC and comparison practices.

Main Results:

• Patient experience ratings were generally comparable between CPC and comparison practices.
• Small, statistically significant improvements were observed in CPC practices for timely access to care and provider support for patient self-care.
• CPC practices showed a slight positive effect on discussions about medication decisions.

Conclusions:

• The CPC initiative did not negatively impact patient experience and led to slight improvements in specific areas.
• Patient experience ratings between CPC and comparison groups were largely similar.
• Both CPC and comparison practices have significant opportunities to enhance the overall patient experience.