Primary Care Continuity, Frequency, and Regularity Associated With Medicare Savings

Area of Science:

• Health Services Research
• Health Economics
• Primary Care Medicine

Background:

• Reducing Medicare expenditures is a priority, with value-based care models emphasizing primary care.
• The optimal organization of primary care visits to maximize Medicare savings is not well understood.

Purpose of the Study:

• To investigate the relationship between primary care visit patterns and Medicare savings.
• To determine how visit frequency, regularity, and continuity impact healthcare expenditures and utilization.

Main Methods:

• Retrospective cohort study using a 5% sample of traditional Medicare claims (2016-2019).
• Included beneficiaries with at least 3 primary care visits and 180 days between the first and last visit, excluding Medicare Advantage enrollees, those with end-stage kidney disease, or institutionalized individuals.
• Analyzed data on visit frequency, regularity, continuity, Medicare expenditures, emergency department visits, and hospitalizations.

Main Results:

• Regular and highly continuous primary care visits were linked to the greatest Medicare savings (175.87%).
• These patterns also correlated with reduced risk-adjusted expenditures (-16.61%), emergency department visits (-40.49%), and hospitalizations (-53.32%).
• Savings increased with visit frequency, particularly for complex patients, and this association inverted with decreased regularity and continuity.

Conclusions:

• Primary care visit frequency, regularity, and continuity are interrelated factors influencing Medicare savings and acute care utilization.
• Optimizing these visit patterns offers substantial potential for improving outcomes and reducing costs within Medicare's value-based care transition.