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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