Primary Care Physician Continuity Is a Consistent Measure Associated with Lower Costs and Hospitalizations

Area of Science:

• Health Services Research
• Health Economics
• Primary Care Medicine

Background:

• Continuity of primary care is linked to reduced costs and hospitalizations within one year.
• Long-term effects of primary care continuity on healthcare spending and utilization are not well understood.
• This knowledge gap is critical for the success of value-based payment models.

Purpose of the Study:

• To investigate the association between physician-level continuity and healthcare expenditures and utilization.
• To examine these associations across different measurement periods, from one to five years.
• To inform value-based payment programs by assessing the optimal timeframe for measuring physician continuity.

Main Methods:

• Retrospective cohort study utilizing Medicare Fee-for-Service (FFS) claims data from 2011-2017.
• Physician continuity was measured using 1- to 5-year lookback periods.
• Generalized linear models and logit models were used to assess expenditures, hospitalizations, and emergency department visits, adjusting for patient and physician factors.

Main Results:

• Higher physician continuity was associated with significantly lower total expenditures (7.4%-10.4%) and reduced odds of hospitalization (5.5%-8.6%) and ED visits (4.9%-6.3%).
• The strongest associations were observed with a 1-year lookback period.
• These effects showed slight attenuation with longer lookback periods, indicating consistent impact.

Conclusions:

• Physician continuity demonstrates a consistent association with decreased healthcare costs, hospitalizations, and emergency department visits across various measurement durations.
• The stability of these findings suggests that a 1-year assessment period is adequate for evaluating physician continuity.
• A 1-year measurement timeframe can effectively support physician continuity evaluation within value-based payment programs.