The 6 attributes of high-value primary care

A study, published in the Annals of Family Medicine, examined the care delivery attributes associated with value in primary care.

Researchers analyzed commercial health insurance claims data, between 2009 to 2011, from more than 40 million preferred provider organization patients, attributing to 53,000-plus primary care practice sites.

Researchers identified sites ranking favorably both in terms of quality and low total annual per capita healthcare spending, which were denoted as high-value sites. They also identified sites ranked near the median, which were denoted as average-value sites. For qualitative assessment, researchers selected sites from 64 high-value sites and 102 average-value sites with more than one primary care physician.

Additionally, physicians, who were experienced in primary care assessment and blinded to site rankings, visited 12 high-value sites and four average-value sites to "identify tangible attributes of care delivery that could plausibly explain a high ranking on value," the study notes.

Researchers found 13 attributes of care delivery that distinguished sites in the high-value cohort, of which the following six attained statistical significance:

•    Decision support for evidence-based medicine
•    Risk-stratified care management
•    Careful selection of specialists
•    Coordination of care
•    Standing orders and protocols
•    Balanced physician compensation

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