Estimating the Costs of Supporting Primary Care Practice Transformation (R03)

项目摘要/摘要 新的患者护理模式，如以患者为中心的医疗之家(PCMH)，对创新至关重要 以及改善初级保健的提供。到目前为止，大多数研究都集中在交付上 机制，如何最好地实施实践转型，以及对患者护理质量和 健康结果。然而，还没有研究评估与改造初级卫生设施相关的成本 对PCMH的护理实践。缺乏可靠的成本研究使实践者难以考虑和规划 用于PCMH转型和政策制定者评估PCMH的相关政策。在建议的 研究，我们将通过收集PCMH改造的直接和间接成本数据来填补这一空白 已经经历了这个过程的实践。这将是第一次评估这些成本的研究，因此 将对PCMH转型决策和政策制定起到至关重要的作用。 我们的研究团队目前正在对初级保健实践的效果进行大规模研究 八个州的转型，名为多支付者高级初级保健实践(MAPCP)，得到资助 由医疗保险和医疗补助服务中心(CMS)提供。我们建议对参与的实践进行调查 本研究旨在获取有关实践转型成本的补充数据。CMS与实践 参加MAPCP示范项目的人表示有兴趣了解成本 与初级保健实践转型相关，因此调查参与度预计会很高。通过 在MAPCP示范项目的基础上，拟议的成本研究将利用这一巨大的 和相对多样化的初级保健做法样本，这些做法已经经历了转型，并将 能够使用在MAPCP项目中收集的详细数据。 我们将调查MAPCP实践，了解实践转型的每个要素的成本，并使用 检查以下研究问题的数据： ？每个实践转型要素的平均转型成本是多少？ ？成本在各资源组成部分(劳动力、顾问、 材料/差旅/服务和合同服务)？ 转型成本如何因实践特征(如规模和地理位置)而变化？ 将转型的成本与我们在MAPCP的另一项研究中衡量的收益捆绑在一起， PCMH改造的成本效益？ 这些研究问题将为考虑PCMH的实践提供必要的信息 对于权衡推动PCMH转型的成本和收益的政策制定者来说，这是一个非常重要的问题。

PROJECT SUMMARY/ABSTRACT Novel patient care models, such as patient-centered medical homes (PCMH), are critical for innovating and improving the delivery of primary care. To date, the majority of research has focused on delivery mechanisms, how best to implement practice transformation, and the effects on patient care quality and health outcomes. However, no research has yet evaluated the costs associated with transforming primary care practices to PCMH. The lack of reliable cost studies makes it difficult for practices to consider and plan for PCMH transformation and for policy makers to evaluate policies around PCMH. In the proposed research, we will fill this gap by collecting direct and indirect cost data on PCMH transformation from practices that have gone through the process. This will be the first research to evaluate these costs and so will be essential to informing PCMH transformation decisions and policy making. Our research team is currently conducting a large study of the effect of primary care practice transformation in eight states entitled Multi-payer Advanced Primary Care Practice (MAPCP) that is funded by the Centers for Medicare & Medicaid Services (CMS). We propose to survey the practices participating in this study to acquire supplemental data on the costs of practice transformation. Both CMS and the practices participating in the MAPCP Demonstration Project have expressed interest in understanding the costs associated with primary care practice transformation, so survey participation is expected to be strong. By building off of the MAPCP Demonstration Project, the proposed cost study will take advantage of this large and relatively diverse sample of primary care practices that have already gone through transition and will be able to use the detailed data collected in the MAPCP project. We will survey MAPCP practices about the costs of each element of practice transformation and use the data to examine the following research questions: ¿ What is the average cost of transformation for each practice transformation element? ¿ What is the distribution of costs across resource components (labor, consultants, materials/travel/services, and contracted services) for each practice transformation element? ¿ How do transformation costs vary by practice characteristics, such as size and geography? ¿ Tying the costs of transformation to the benefits measured in our other MAPCP research, what is the cost-effectiveness of PCMH transformation? These research questions will provide essential information for practices considering PCMH transformation and for policy makers weighing the costs and benefits of promoting PCMH transformation.