Staff Engagement in the Implementation of a Primary Care Value-Based Payment Program Increases Outpatient Care...

Area of Science:

• Health Services Research
• Health Economics
• Primary Care Medicine

Background:

• Value-based payment (VBP) models are increasingly adopted in primary care to improve healthcare quality and efficiency.
• Understanding the impact of these models on patient healthcare utilization and the experiences of clinics implementing them is crucial.

Purpose of the Study:

• To examine the effect of a primary care VBP model (PCPM) on patient healthcare utilization.
• To capture the implementation experiences of clinics participating in the PCPM model.

Main Methods:

• Convergent parallel mixed-methods study design.
• Quantitative analysis: Difference-in-differences model comparing outpatient utilization between PCPM and non-PCPM clinics using Oregon's All Payer All Claims (APAC) data (N=139,402).
• Qualitative analysis: Semi-structured interviews with 12 operational/administrative staff at 7 PCPM clinics.

Main Results:

• PCPM patients showed significantly greater connection to primary care (4.2 pp increase) and specialty care (1.1 pp increase) compared to the control group.
• Among users, primary care visits increased by 136.9 per 1000 member months, and specialty care visits by 32.1 per 1000 member months.
• Qualitative findings highlighted the importance of staff communication, involvement in workflow creation, and access to program data for successful implementation and improved patient care.

Conclusions:

• The PCPM model led to increased utilization of both primary and specialty care.
• Successful VBP implementation relies on engaging care team staff and demonstrating the direct link between VBP initiatives and improved patient outcomes.
• Motivating staff through clear connections to patient care benefits can enhance engagement and improve overall patient connection to services.