CONCLUSION
The PHITA offers a way to quickly assess the ability of clinical practices to report CQMs. Substantial proportions of primary care practices are inadequately prepared for the reporting and analytic requirements of value-based reimbursement. The gap is greatest in independent practices, which are also those least likely to have resources to pay for technical assistance. If these practices are to successfully transition to value-based reimbursement, stable funding for TA will need to be an integral part of national health policy. TA can target the elements of Health IT preparedness identified by the PHITA, and help small-to-medium sized practices identify and overcome the barriers they face meeting the requirements for value-based reimbursement.
References:
  1. Casalino LP, Gans D, Weber R, et al. US Physician Practices Spend More Than $15.4 Billion Annually To Report Quality Measures. Health Affairs. 2016;35(3):1-6.
  2. Meigs SL, Solomon M. Electronic Health Record Use a Bitter Pill for Many Physicians. Perspectives in Health Information Management. 2016;(Winter):1-17.
  3. Arndt B, Beasley JW, Watkinson MD, et al. Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations. Annals of Family Medicine. 2017;15(5):419-426.
  4. Cohen DJ, Dorr DA, Knierem K, Dubard CA, Hemler JR, Hall JD, Marino M, Solberg LI, McConnell KJ, Nichols LM, Nease DE, Edwards ST, Wu WY, Pham-Singer H, Ko AN, Phillips RL, Rasmussen LV, Duffy FD, Balasubramanian BA. Primary Care Practice’s Abilities And Challenges In Using Electronic Health Record Data For Quality Improvement. Health Affairs. 2018;37(4):635-643.
  5. Cohen DJ, Balasubramanian BA, Gordon L, et al. A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol. Implementation Science. 2016; 11(68): 1-13.
  6. Balasubramanian BA, Marino M, Cohen DJ, et al. Use of Quality Improvement Strategies Among Small to Medium-Size US Primary Care Practices. Ann Fam Med. 2018;16:S35-43.
  7. Buchholz L. EvidenceNOW Grants Focus on Heart Disease Care in Small Practices. JAMA.  2015;314(2):115. doi:10.1001/jama.2015.7036.
  8. Qualis Oral Health Integration Implimentation Guide 2014. http://www.qualishealth.org/sites/default/files/Guide-Oral-Health-Integration.pdf viewed 10/27/2019.
  9. Dorr DA, Cohen DJ, Alder-Milstein J. Data Driven Diffusion of Innovations: Successes and Challenges in 3 Large-Scale Innovative Delivery Models. Health Aff. 2018;37(2):257-265.
  10. Friedberg MW, Chen PG, Simmons P, Sherry T, Mendel P, Raaen L, Ryan J, Orr P, Vargo C, Caralasare L, Botts C, Blake K. Effects of Health Care Payment Models on Physician Practice in the United States: Follow-Up Study. 2018; RAND Corporation, Santa Monica, California. https://www.rand.org/pubs/research_reports/RR2667.html (accessed 2019.09.22)
  11. Parchman ML, Fagnan LJ, Dorr DA, et al. Study Protocol for “Healthy Hearts Northwest”: A 2x2 randomized factorial trial to build quality improvement capacity in primary care. Implementation Science. 2016;11:138.
  12. Parchman ML, Anderson ML, Dorr DA, Fagnan LJ, O’Meara ES, Tuzzio L, Penfold RB, Cook AJ, Hummel J5 Conway C, Cholan R, Baldwin LM. A randomized trial of external practice support to improve cardiovascular risk factors in primary care. Ann Fam Med. 2019;17(Suppl 1): S40-49.
  13. Hummel J, Phillips KE. A Population Management Approach to Oral Health. Journal of the California Dental Association. 2016 Mar. 167-172.
  14. Hart LG, Larson EH, Lishner DM. Rural definitions for health policy and research. Am J Public Health. 2005;95(7):1149-1155.
  15. Crabtree BF, Miller WL. Chapter 10: Immersion/Crystallization.  In: Crabtree BF, Miller WL, editors. Doing qualitative research. 2nd ed. Thousand Oaks, CA: Sage Publications; 1999. p 163-77.
  16. Muhr T. ATLAS.ti. Berlin, Germany: ATLAS.ti Scientific Software Development GmbH; 1993.
  17. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007 Dec;19(6):349-57. DOI: https://doi.org/10.1093/intqhc/mzm042
  18. Nagykaldi Z, Mold JW, Robinson A, Niebauer L, Ford A. Practice facilitators and practice-based research networks. J Am Board Fam Med. 2006;19(5):506–10.
  19. Berta W, Cranley L, Dearing JW, Dogherty EJ, Squires JE, Estabrooks CA. Why (we think) facilitation works: insights from organizational learning theory. Implement Sci. 2015;10:141.