Healthcare reform programs have not succeeded in broadly engaging primary care organizations despite years of effort, a new AHRQ-funded study has found, announced the National Library of Medicine, part of the National Institutes of Health (NIH).
The study, published in Health Services Research, reviewed participation by the nation’s more than 56,000 organizations that deliver primary care services in three major reform programs: Medicare and Medicaid Promoting Interoperability Programs, commonly known as Meaningful Use; the Medicare Shared Savings Program; and the National Committee for Quality Assurance’s Patient-Centered Medical Home program.
Researchers found that 50% of primary care organizations participated in at least one program but only 1% participated in all three. Just over 14% of organizations participated in five or more years of Meaningful Use, but less than 1% participated in five or more years of the Patient-Centered Medical Home program. Researchers concluded that organizations participating in multiple programs are likely those already providing high-quality care.
No program achieved more than 50% participation across the 56,287 organizations in a given year, and participation levels flattened or decreased in later years. 36% of organizations did not participate in any program over the eight-year study period; 50% participated in one; 13% in two; and 1% in all three. 14.31% of organizations participated in five or more years of Meaningful Use while 3.84% of organizations participated in five years of the MSSP ACO Program and 0.64% participated in at least five years of PCMH. Larger organizations, those with younger providers, those with more primary care providers, and those with larger Medicare patient panels were more likely to participate in more programs.
The report concludes that primary care transformation via use of voluntary programs, each with their own participation requirements and approach to incentives, has failed to broadly engage primary care organizations. Those that have chosen to participate in multiple programs are likely those already providing high-quality care.
