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Related Experiment Video

Updated: Jun 20, 2025

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Practice Transformation in the Transforming Clinical Practice Initiative and Emergency Department Use.

Lori Timmins1, Suzanne Felt-Lisk2, Wenjia Zhu3

  • 1Mathematica, Chicago, Illinois ltimmins@mathematica-mpr.com.

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|July 22, 2024
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Improving ambulatory care practices through transformation is linked to fewer emergency department (ED) visits. Enhanced primary and specialty care reduced ED visits significantly, highlighting the impact of practice transformation.

Keywords:
Medicareambulatory careemergency departmentpractice transformation

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Area of Science:

  • Health Services Research
  • Clinical Practice Improvement
  • Healthcare Management

Background:

  • Emergency department (ED) visits represent a significant cost and burden on healthcare systems.
  • Ambulatory care practices play a crucial role in managing patient health and preventing unnecessary ED utilization.
  • The Transforming Clinical Practice Initiative aimed to enhance care delivery models.

Purpose of the Study:

  • To investigate the association between practice transformation in ambulatory care and emergency department (ED) visit rates.
  • To quantify the impact of different levels of practice transformation on ED utilization for primary and specialty care.
  • To identify specific domains of practice transformation that contribute to reduced ED visits.

Main Methods:

  • A comparative study of 3,773 Medicare primary and specialty care practices participating in the Transforming Clinical Practice Initiative.
  • Analysis of practice transformation scores over a 6-year period ending in 2021, using data from a practice transformation assessment tool.
  • Statistical comparison of ED visit rates between practices with higher versus lower transformation levels, assessed 3 to 4 years post-initial assessment.

Main Results:

  • Improved transformation scores were associated with a 6% reduction in ED visits for primary care practices.
  • Specialty care practices with improved transformation scores showed a 4% reduction in ED visits.
  • Transformation across 5 out of 8 assessed domains was found to contribute to the reduction in ED visits.

Conclusions:

  • Practice transformation in ambulatory care settings is an effective strategy for reducing emergency department (ED) visits.
  • Targeted improvements in specific domains of clinical practice can lead to significant decreases in ED utilization.
  • These findings support the integration of practice transformation initiatives to optimize healthcare delivery and resource allocation.