Overview

This trial is active, not recruiting.

Condition chronic diseases
Treatment alternative payment model
Sponsor Oregon Health and Science University
Collaborator Ochin, Inc.
Start date July 2015
End date May 2019
Trial size 8 participants
Trial identifier NCT02637869, RWJF grant #71125

Summary

The investigators are conducting a prospective analysis of the Alternative Payment Methodology (APM) demonstration project sites. The investigators' goal is to conduct a cross project analysis of findings. The investigators propose to use mixed methods to study processes and outcomes associated with the APM natural experiment in payment reform. The investigators hypothesize that Community Health Centers (CHCs) participating in the APM demonstration project will redesign their workflows to better focus on patient and population health needs, resulting in reallocation of financial resources, lower overall costs, changes in utilization patterns, and improved quality.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Observational model case control
Time perspective prospective
Arm
Clinics that did not participate in the APM project
Oregon developed an Alternative Payment Methodology (APM). Under this APM pilot participating CHCs will receive a prospective payment system (PPS) payment as a capitated equivalent in a per-member-per-month rate for all of their Medicaid patients
alternative payment model
Oregon developed an Alternative Payment Methodology (APM). Under this APM pilot participating CHCs will receive a prospective payment system (PPS) payment as a capitated equivalent in a per-member-per-month rate for all of their Medicaid patients

Primary Outcomes

Measure
Internal services utilization
time frame: ≤3 years pre-APM implementation and ≤3 years post

Secondary Outcomes

Measure
Quality care measures
time frame: ≤3 years pre-APM implementation and ≤3 years post
External services utilization
time frame: ≤3 years pre-APM implementation and ≤3 years post
Medicaid expenditures
time frame: ≤3 years pre-APM implementation and ≤3 years post

Eligibility Criteria

Male or female participants from 2 years up to 64 years old.

Inclusion Criteria: 1. Total clinic population: established patients at intervention and control clinics aged 2-64 2. Medicaid Population: Medicaid-enrolled patients at intervention and control clinics aged 2-64 Exclusion Criteria: 1. Total clinic population: non-established patients at intervention and control clinics aged 2-64 2. Medicaid Population: non-Medicaid-enrolled patients at intervention and control clinics aged 2-64

Additional Information

Official title Evaluating Community Health Centers' Adoption of a New Global Capitation Payment
Principal investigator Jennifer E DeVoe, MD, DPhil
Description Led by the Oregon Primary Care Association, three community health center (CHC) organizations in Oregon developed an Alternative Payment Methodology (APM). Under this APM pilot participating CHCs will receive a prospective payment system (PPS) payment as a capitated equivalent in a per-member-per-month rate for all of their Medicaid patients. Oregon CHC organizations (several clinic sites) implemented Phase I of this demonstration project on March 1, 2013; Phase IIA was implementedon July 1, 2014; Phase IIB on October 1, 2014; and Phase III began July 1, 2015. We are a prospective analysis of the APM project sites. We propose to use mixed methods to study processes and outcomes associated with the APM natural experiment in payment reform. We hypothesize that CHCs participating in the APM demonstration project will redesign their workflows to better focus on patient and population health needs, resulting in reallocation of financial resources, lower overall costs, changes in utilization patterns, and improved quality. The study will include baseline qualitative data collection as clinics are transitioning to the APM methodology. We will conduct 2 site visits to each intervention clinic to observe practice changes that occurred post APM-implementation (first visit approximately 12-18 months post-APM implementation; second visit approximately 30-36 months post-APM implementation). We will also assemble and analyze of pre-post quantitative and qualitative datasets, and interpretation and dissemination of study findings.
Trial information was received from ClinicalTrials.gov and was last updated in May 2016.
Information provided to ClinicalTrials.gov by Oregon Health and Science University.