Patient-Reported Care Coordination is Associated with Better Performance on Clinical Care Measures.
Medicare Advantage CAHPS
care continuity
patient experience
quality of ambulatory care
Journal
Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
16
07
2020
accepted:
26
08
2021
pubmed:
22
9
2021
medline:
21
1
2022
entrez:
21
9
2021
Statut:
ppublish
Résumé
Prior studies using aggregated data suggest that better care coordination is associated with higher performance on measures of clinical care process; it is unclear whether this relationship reflects care coordination activities of health plans or physician practices. Estimate within-plan relationships between beneficiary-reported care coordination measures and HEDIS measures of clinical process for the same individuals. Mixed-effect regression models in cross-sectional data. 2013 Medicare Advantage CAHPS respondents (n=152,069) with care coordination items linked to independently collected HEDIS data on clinical processes. Care coordination measures assessed follow-up, whether doctors had medical records during visits, whether doctors discussed medicines being taken, how informed doctors seemed about specialist care, and help received with managing care among different providers. HEDIS measures included mammography, colorectal cancer screening, cardiovascular LDL-C screening, controlling blood pressure, 5 diabetes care measures (LDL-C screening, retinal eye exam, nephropathy, blood sugar/HbA1c <9%, LCL-C<100 mg/dL), glaucoma screening in older adults, BMI assessment, osteoporosis management for women with a fracture, and rheumatoid arthritis therapy. For 9 of the 13 HEDIS measures, within health plans, beneficiaries who reported better care coordination also received better clinical care (p<0.05) and none of the associations went in the opposite direction; HEDIS differences between those with excellent and poor coordination exceeded 5 percentage points for 7 measures. Nine measures had positive associations (breast cancer screening, colorectal cancer screening, cardiovascular care LDL-C screening, 4 of 5 diabetes care measures, osteoporosis management, and rheumatoid arthritis therapy). Within health plans, beneficiaries who report better care coordination also received higher-quality clinical care, particularly for care processes that entail organizing patient care activities and sharing information among different healthcare providers. These results extend prior research showing that health plans with better beneficiary-reported care coordination achieved higher HEDIS performance scores.
Sections du résumé
BACKGROUND
Prior studies using aggregated data suggest that better care coordination is associated with higher performance on measures of clinical care process; it is unclear whether this relationship reflects care coordination activities of health plans or physician practices.
OBJECTIVE
Estimate within-plan relationships between beneficiary-reported care coordination measures and HEDIS measures of clinical process for the same individuals.
DESIGN
Mixed-effect regression models in cross-sectional data.
PARTICIPANTS
2013 Medicare Advantage CAHPS respondents (n=152,069) with care coordination items linked to independently collected HEDIS data on clinical processes.
MAIN MEASURES
Care coordination measures assessed follow-up, whether doctors had medical records during visits, whether doctors discussed medicines being taken, how informed doctors seemed about specialist care, and help received with managing care among different providers. HEDIS measures included mammography, colorectal cancer screening, cardiovascular LDL-C screening, controlling blood pressure, 5 diabetes care measures (LDL-C screening, retinal eye exam, nephropathy, blood sugar/HbA1c <9%, LCL-C<100 mg/dL), glaucoma screening in older adults, BMI assessment, osteoporosis management for women with a fracture, and rheumatoid arthritis therapy.
KEY RESULTS
For 9 of the 13 HEDIS measures, within health plans, beneficiaries who reported better care coordination also received better clinical care (p<0.05) and none of the associations went in the opposite direction; HEDIS differences between those with excellent and poor coordination exceeded 5 percentage points for 7 measures. Nine measures had positive associations (breast cancer screening, colorectal cancer screening, cardiovascular care LDL-C screening, 4 of 5 diabetes care measures, osteoporosis management, and rheumatoid arthritis therapy).
CONCLUSIONS
Within health plans, beneficiaries who report better care coordination also received higher-quality clinical care, particularly for care processes that entail organizing patient care activities and sharing information among different healthcare providers. These results extend prior research showing that health plans with better beneficiary-reported care coordination achieved higher HEDIS performance scores.
Identifiants
pubmed: 34545472
doi: 10.1007/s11606-021-07122-8
pii: 10.1007/s11606-021-07122-8
pmc: PMC8642573
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
3665-3671Informations de copyright
© 2021. Society of General Internal Medicine.
Références
Ann Intern Med. 2012 Oct 2;157(7):482-9
pubmed: 23027319
J Gen Intern Med. 2015 Feb;30(2):253-6
pubmed: 25416601
JAMA Surg. 2013 Apr;148(4):362-7
pubmed: 23715968
N Engl J Med. 2015 Mar 5;372(10):897-9
pubmed: 25622024
N Engl J Med. 2007 Jun 14;356(24):2496-504
pubmed: 17568030
Med Care. 2018 Aug;56(8):736-739
pubmed: 29939911
N Engl J Med. 2013 Jan 17;368(3):201-3
pubmed: 23268647
Pediatrics. 2008 Jul;122(1):e209-16
pubmed: 18595966
Arch Pediatr Adolesc Med. 2000 May;154(5):499-506
pubmed: 10807303
Fam Med. 2004 Jan;36(1):15-21
pubmed: 14710324
Circ Cardiovasc Qual Outcomes. 2010 Mar;3(2):188-95
pubmed: 20179265
Health Serv Res. 2010 Aug;45(4):1024-40
pubmed: 20528990
N Engl J Med. 2014 Aug 7;371(6):489-91
pubmed: 25099572
N Engl J Med. 2007 Mar 15;356(11):1130-9
pubmed: 17360991
Popul Health Manag. 2019 Oct;22(5):406-414
pubmed: 30648928
Pediatrics. 2004 May;113(5 Suppl):1507-16
pubmed: 15121919
Popul Health Manag. 2020 Feb;23(1):59-67
pubmed: 31107162
Health Serv Res. 2013 Jun;48(3):913-30
pubmed: 23046097
PLoS One. 2013;8(4):e61097
pubmed: 23577195
Arch Pediatr Adolesc Med. 2004 Jan;158(1):78-82
pubmed: 14706963
BMJ. 2009 Sep 29;339:b3851
pubmed: 19808811
Med Care Res Rev. 2014 Apr;71(2):192-202
pubmed: 24227813
Gen Hosp Psychiatry. 2017 Jan - Feb;44:10-15
pubmed: 28041570
JAMA. 2012 May 2;307(17):1805-6
pubmed: 22550194
Am J Manag Care. 2011 Jan;17(1):41-8
pubmed: 21348567
N Engl J Med. 2014 Jan 9;370(2):99-101
pubmed: 24350900
N Engl J Med. 2008 Oct 30;359(18):1921-31
pubmed: 18971493
Am J Med Qual. 2003 Mar-Apr;18(2):59-65
pubmed: 12710554
N Engl J Med. 2008 Mar 6;358(10):1064-71
pubmed: 18322289
J Fam Pract. 1998 Sep;47(3):213-20
pubmed: 9752374
Health Serv Res. 2013 Jun;48(3):905-12
pubmed: 23656501
Med Care. 2001 Dec;39(12):1313-25
pubmed: 11717573
EGEMS (Wash DC). 2017 Jan 13;4(1):1276
pubmed: 28203612
J Gen Intern Med. 2001 Dec;16(12):800-8
pubmed: 11903758
Diabetes Res Clin Pract. 2006 Jan;71(1):28-35
pubmed: 16019102
Health Serv Res. 2013 Oct;48(5):1730-49
pubmed: 23557249
Ann Intern Med. 2004 Oct 5;141(7):533-6
pubmed: 15466770
BMC Health Serv Res. 2013 Mar 28;13:119
pubmed: 23537350
Health Serv Res. 2010 Oct;45(5 Pt 1):1188-204
pubmed: 20662947
Health Aff (Millwood). 2010 Apr;29(4):718-24
pubmed: 20167626
Med Care. 1998 Aug;36(8 Suppl):AS21-30
pubmed: 9708580