Funding received to quantitatively assess the impact of APM on service utilization, quality, and cost of healthcare

Funding received to quantitatively assess the impact of APM on service utilization, quality, and cost of healthcare

Authors: Heather Angier, Erika Cottrell, David Cameron

We are excited to report that our research team received funding from the Agency for Healthcare Research and Quality to conduct quantitative analyses assessing the impact of the innovative APM natural experiment. Led by Jen DeVoe, MD, DPhil, the Evaluating Community Health Centers’ Adoption of a New Global Capitation Payment (eCHANGE) project will utilize electronic health record and Medicaid claims data to study changes in service utilization, quality and cost of healthcare when community health centers (CHCs) shift from fee-for-service to global per-member per-month (PMPM) capitation payments. This study expands on our qualitative evaluation, which collected invaluable baseline data from Phase 1 of the APM demonstration project.

The eCHANGE study will compare key measures of service utilization, quality, and cost of healthcare before and after APM implementation in the 8 Phase 1 CHC clinics to understand the impact of APM. To isolate the APM impact from other concurrent primary care delivery transformation initiatives, we will match each Phase 1 intervention site with a non-intervention (or ‘control’) site that is similar on a number of factors – such as patient population, geography, and clinic size – but has not implemented APM.

Findings from eCHANGE will have national relevance and will help inform the efforts of other states who are interested in implementing APMs. Specifically, insight gained through this study has the potential to greatly improve primary care delivery and patient health by:

  • Filling a critical knowledge gap: understanding whether APMs can improve patient health at reduced cost is imperative as traditional fee-for-service reimbursement models are not achieving improvements;
  • Measuring the real-time effects of health policy changes on care delivery in CHCs;
  • Evaluating the APM ‘natural experiment’ to assess service utilization, quality of care, and cost of healthcare;
  • Engaging CHCs in a study that will inform ongoing / future policy and practice changes; and
  • Informing the potential dissemination of APM methods to additional CHCs and/or other primary care settings.