Care Transformation Organization Partnerships Are Associated with Increased Care Management Capabilities Among MDPCP...

Area of Science:

• Health Services Research
• Primary Care Innovation
• Healthcare Policy

Background:

• Traditional fee-for-service models hinder primary care investment in care management, especially for rural and minority-serving practices.
• The Maryland Primary Care Program (MDPCP) introduced Care Transformation Organizations (CTOs) to enable external partnerships for enhanced care delivery.
• MDPCP features three CTO partnership levels (50%, 30%, 0% care management services) with limited evidence on their impact.

Purpose of the Study:

• To examine the association between CTO partnerships and the comprehensiveness of care management within primary care practices.
• To evaluate the effectiveness of different CTO partnership levels in improving care management delivery.

Main Methods:

• Utilized data from CMS Claims, MDPCP, and care transformation reports (2020-2023).
• Employed linear mixed-effects and generalized linear mixed-effects models.
• Assessed 486 MDPCP primary care practices to determine the association between CTO partnership levels and composite care management scores.

Main Results:

• Both CTO 30% and CTO 50% partnerships demonstrated a significant association with higher comprehensive care management scores compared to the CTO 0% option.
• An increase of +0.14-0.15 points in comprehensive care management scores was observed for CTO 30% and 50% partnerships.

Conclusions:

• CTO partnerships are linked to more comprehensive care management services in primary care.
• These partnerships offer a potential mechanism to engage smaller, rural, and high-needs practices in primary care demonstrations.
• Future efforts can leverage CTO models to broaden participation in value-based care initiatives.