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Association of Team-Based Primary Care with Health Care Utilization and Costs Among Chronically Ill Patients

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Association of Team-Based Primary Care with Health Care Utilization and Costs Among Chronically Ill Patients Research JAMA Internal Medicine | Original Investigation Association of Team-Based Primary Care With Health Care Utilization and Costs Among Chronically Ill Patients David J. Meyers, MPH; Alyna T. Chien, MD, MS; Kevin H. Nguyen, MS; Zhonghe Li, MS; Sara J. Singer, MBA, PhD; Meredith B. Rosenthal, PhD Invited Commentary page 61 IMPORTANCE Empirical study findings to date are mixed on the association between Supplemental content team-based primary care initiatives and health care use and costs for Medicaid and commercially insured patients, especially those with multiple chronic conditions. OBJECTIVE To evaluate the association of establishing team-based primary care with patient health care use and costs. DESIGN, SETTING, AND PARTICIPANTS We used difference-in-differences to compare preutilization and postutilization rates between intervention and comparison practices with inverse probability weighting to balance observable differences. We fit a linear model using generalized estimating equations to adjust for clustering at 18 academically affiliated primary care practices in the Boston, Massachusetts, area between 2011 and 2015. The study included 83 953 patients accounting for 138 113 patient-years across 18 intervention practices and 238 455 patients accounting for 401 573 patient-years across 76 comparison practices. Data were analyzed between April and August 2018. EXPOSURES Practices participated in a 4-year learning collaborative that created and supported team-based primary care. MAIN OUTCOMES AND MEASURES Outpatient visits, hospitalizations, emergency department visits, ambulatory care–sensitive hospitalizations, ambulatory care–sensitive emergency department visits, and total costs of care. RESULTS Of 322 408 participants, 176 259 (54.7%) were female; 64 030 (19.9%) were younger than 18 years and 258 378 (80.1%) were age 19 to 64 years. Intervention practices had fewer participants, with 2 or more chronic conditions (n = 51 155 [37.0%] vs n = 186 954 [46.6%]), more participants younger than 18 years (n = 337 931 [27.5%] vs n = 74 691 [18.6%]), higher Medicaid enrollment (n = 39 541 [28.6%] vs n = 81 417 [20.3%]), and similar sex distributions (75 023 women [54.4%] vs 220 097 women [54.8%]); however, after inverse probability weighting, observable patient characteristics were well balanced. Intervention practices had higher utilization in the preperiod. Patients in intervention practices experienced a 7.4% increase in annual outpatient visits relative to baseline (95% CI, Author Affiliations: Department of Health Services, Policy, and Practice, 3.5%-11.3%; P < .001) after adjusting for patient age, sex, comorbidity, zip code level Brown University School of Public sociodemographic characteristics, clinician characteristics, and plan fixed effects. In a Health, Providence, Rhode Island subsample of patients with 2 or more chronic conditions, there was a statistically significant (Meyers, Nguyen); Department of 18.6% reduction in hospitalizations (95% CI, 1.5%-33.0%; P = .03), 25.2% reduction in Pediatrics, Harvard Medical School, Division of General Pediatrics, emergency department visits (95% CI, 6.6%-44.0%; P = .007), and a 36.7% reduction in Department of Medicine, Boston ambulatory care–sensitive emergency department visits (95% CI, 9.2%-64.0%; P = .009). Children’s Hospital, Boston, Among patients with less than 2 comorbidities, there was an increase in outpatient visits Massachusetts (Chien); Department (9.2%; 95% CI, 5.10%-13.10%; P < .001), hospitalizations (36.2%; 95% CI, 12.2-566.6; of Health Policy and Management, Harvard T.H. Chan School of Public P = .003), and ambulatory care–sensitive hospitalizations (50.6%; 95% CI, 7.1%-329.2%; Health, Boston, Massachusetts (Li, P = .02). Rosenthal); Department of Medicine, Stanford University School of CONCLUSIONS AND RELEVANCE While establishing team-based care was not associated with Medicine, Stanford, California (Singer). differences in the full patient sample, there were substantial reductions in utilization among a Corresponding Author: David J. subset of chronically ill patients. Team-based care practice transformation in primary care Meyers, MPH, Department of Health settings may be a valuable tool in improving the care of sicker patients, thereby reducing Services, Policy, and Practice, Brown avoidable use; however, it may lead to greater use among healthier patients. University School of Public Health, 121 S Main St, Box G-S121-3, JAMA Intern Med. 2019;179(1):54-61. doi:10.1001/jamainternmed.2018.5118 Providence, RI 02912 (david_meyers Published online November 26, 2018. @brown.edu). 54 (Reprinted) jamainternalmedicine.com © 2018 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/23/2021 Association of Team-Based Primary Care With Health Care Utilization and Costs Among Chronically Ill Patients Original Investigation Research here is increasing recognition that creating health care teams is critical to improving health care quality and Key Points value. Teaming refers to the dynamic activities, includ- T Question What is the association of a team-based primary care ing coordination and collaboration, that allow individuals to transformation collaborative initiative with patient health care work together to deliver shared goals.1 Some elements of highly utilization and costs? functioning primary care teams and teaming have been de- Findings In this study, among chronically ill patients in 18 scribed in isolated parts of the American health care system, practices who were exposed to team-based care, there was an 2,3 yet team-based care is not the norm. 18% reduction in hospitalizations, a 25% reduction in emergency Past work has found teaming can be effective at improv- department visits, and a 36% reduction in ambulatory ing clinical care and outcomes.4 Introducing teams in hospi- care–sensitive emergency department visits relative to 76 tal settings has reduced mortality and length of stay,4 and care comparison practices. Among healthier patients, there was an delivered by geriatric teams improved elderly patients’ func- increase in outpatient visits and hospitalizations. tional status, mental health, and independence compared with Meaning Team-based approaches to primary care transformation control groups.4-6 Teams based in primary initiatives have may benefit patients with chronic illness by reducing the use of found modest gains, although findings are mixed.7-10 Gaps in acute care; however, it may lead to higher use among healthier the literature remain. More work is needed to understand how patients. academic medical practices’ use of team-based care, how team- based care affects safety net practices, and which patients ben- Required team activities included daily 15-minute “huddles” efit most from these interventions. and implementation of population management systems (eg, sys- In 2012, Harvard Medical School launched the Academic tematic identification and follow-up with patients who required Innovations Collaborative (AIC), a multiyear, multisite care screenings). Team members were required to attend thrice-yearly learning collaborative aimed at establishing team-based care 1.5-day learning sessions and regular interactive webinars to con- at its affiliated primary care practices.11 We examine the asso- nect with other practices and share strategies for improving clini- ciation of this intervention with health care utilization and cal quality through team-based care. To support these efforts, costs. We make several important contributions to the litera- practices received an unrestricted $3 per member per month ture. First, we used an All Payer Claims Database (APCD) that payment to support the transformation process during the provided us with all commercial and Medicaid claims for the first 2 years, and a $0.50 to $1 payment for the latter 2 years of practices in our study, granting us a more complete view of pa- the initiative. These funds could be used by the practice for tient care than single-payer studies. Second, we used a differ- any purpose and did not need to be directly linked to the AIC ence-in-difference approach with inverse probability weight- intervention. ing to isolate the effects of the intervention on patient To date, examinations of the AIC have demonstrated that utilization and costs. Third, our study includes intervention transitions to team-based care involved changing practice con- practices across 6 different academic medical centers, whereas figurations (ie, who worked with whom) and composition past work has typically focused on changes within just (ie, ratios of certain types of personnel to physicians) more than 1 medical center. it changed the overall size of practices (ie, total number of staff within practices).12-17 They have also shown that better team dynamics (eg, team members’ ability to understand each oth- Methods er’s roles) were associated with greater satisfaction with clini- cal work among primary care clinicians and with more posi- Intervention tive perceptions regarding patient safety among all staff. This study was approved by the Harvard T.H. Chan School of Pub- Qualitative studies have illustrated how the establishment of lic Health institutional review board. A waiver of patient consent primary care teams can provide important scaffolding for resi- was granted because the study used administrative data. The AIC dents when they feel stressed and inadequate during conti- initiative was inspired by the need to control increasing health nuity clinic
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