Researchers from National Bureau of Economic Research Discuss Findings in Health and Society (Primary Care Quality and Cost for Privately Insured Patients In and Out of Us Health Systems: Evidence From Four States)

2020 NOV 30 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on Health and Medicine - Health and Society have been published. According to news reporting originating in Cambridge, Massachusetts, by NewsRx journalists, research stated, “To characterize physician health system membership in four states between 2012 and 2016 and to compare primary care quality and cost between in-system providers and non-system providers for the commercially insured population. Physician membership in health systems was obtained from a unique longitudinal database on health systems and matched at the provider level to 2014 all-payer claims data from Colorado, Massachusetts, Oregon, and Utah.”

Financial support for this research came from Agency for Healthcare Research and Quality.

The news reporters obtained a quote from the research from the National Bureau of Economic Research, “Using an observational study design, we compared physicians in health systems to non-system physicians located in the same state and geography on average cost of care (risk-adjusted using the Johns Hopkins’ Adjusted Clinical Grouper), five HEDIS quality measures, one measure of developmental screening, and two Prevention Quality Indicator Measures. Data Collection/Extraction Methods Patients in commercial health plans were attributed to a primary care physician accounting for the plurality of office visits. A cohort for each quality measure was constructed based on appropriate measure specifications. The share of physicians in health systems increased steadily from 2012 to 2016 and ranged from 48% in Colorado to 63% in Utah in 2016. Compared to physicians not in a system, system physicians performed similarly on most HEDIS quality metrics compared to non-system physicians. Patients attributed to in-system physicians had about 40% higher rates (P < .05) of Ambulatory Care Sensitive Admissions (measured in admissions per 100 000:921.33 in-system vs 674.61 not-in-system for acute composite; 2540.91 in-system vs 1972.17 for chronic composite In-system providers were associated with $29 (P < .05) higher average per member per month costs (453.37 vs 432.93). Overall, differences in performance by system membership were relatively small compared to differences across states and geography. A growing share of physicians is part of a health system from 2012 to 2016.”

According to the news reporters, the research concluded: “Providers in health systems are not delivering primary care more efficiently than non-system providers for the commercially insured.”

This research has been peer-reviewed.

For more information on this research see: Primary Care Quality and Cost for Privately Insured Patients In and Out of Us Health Systems: Evidence From Four States. Health Services Research, 2020. Health Services Research can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - http://www.wiley.com/; Health Services Research - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1475-6773)

Our news correspondents report that additional information may be obtained by contacting Ruohua Annetta Zhou, National Bureau of Economic Research, 1050 Massachusetts Ave, Cambridge, MA 02138, United States. Additional authors for this research include Nancy D. Beaulieu and David Cutler.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1111/1475-6773.13590. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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