Evaluating c ommunity h ealth c enters ' a doption of a n ew g lobal c apitation p ayment (eCHANGE) s tudy p rotocol

• Published in: Contemporary clinical trials
• Main Authors: Angier, H, MPH, O'Malley, JP, MPH, Marino, M, PhD, McConnell, KJ, PhD, Cottrell, E, PhD, Jacob, RL, ScM, Likumahuwa-Ackman, S, MID, MPH, Heintzman, J, MD, MPH, Huguet, N, PhD, Bailey, SR, PhD, DeVoe, JE, MD, PhD
• Format: Journal Article
• Language: English
• Published: 2016
• Subjects: Cardiovascular; Hematology, Oncology and Palliative Medicine; OHA; fee-for-service; PBRN; RHC; EHR; federally-qualified health center; FFS; C apitation; coordinated care organization; rural health center; Oregon Health Authority; Medicaid; generalized linear mixed model; PMPM; P atient-centered medical homes; GLMM; FQHC; PCMH; CCO; per-member-per-month; P ayment methodology; practice-based research network; Alternative Payment Methodology; community health center; electronic health record; primary care medical home; APM; CHC
• ISSN: 1551-7144
• DOI: 10.1016/j.cct.2016.11.001

Abstract Primary care patient-centered medical homes (PCMHs) are an effective healthcare delivery model. Evidence regarding the most effective payment models for increased coordination efforts is sparse. This protocol paper describes the evaluation of an Alternative Payment Methodology (APM) implemented in a subset of Oregon community health centers (CHCs), using a prospective matched observational design. The APM is a primary care payment reform intervention that changed Oregon ' s Medicaid payment for several CHCs from fee-for-service reimbursement to a per-member-per-month capitated payment. We will implement a difference-in-difference analytic approach to evaluate pre-post APM changes between intervention and control groups, including: 1) clinic-level outcomes, 2) patient-level clinical outcomes, and 3) patient-level econometric outcomes. Findings from the project will be of national significance, as there is a need for evidence regarding how novel payment methods might enhance PCMH capabilities and support their capacity to produce better quality and outcomes. If this capitated payment method is proven effective, study findings will inform dissemination of similar APMs nationwide.