Address correspondence to Douglas Conrad, Ph.D., Department of Health Services, University of Washington, Box 357660, Suite H660C, Seattle, WA 98195-7660; e-mail: firstname.lastname@example.org. Paul Fishman, Ph.D., James Ralston, M.D., M.P.H., Robert Reid, M.D., Ph.D., Eric Larson, M.D., M.P.H., and Melissa Anderson, M.S., are with the Group Health Center for Health Studies, Seattle, WA. David Grembowski, Ph.D., and Diane Martin, Ph.D., are with the Department of Health Services, University of Washington, Seattle, WA.
Access Intervention in an Integrated, Prepaid Group Practice: Effects on Primary Care Physician Productivity
Article first published online: 25 JUL 2008
© Health Research and Educational Trust
Health Services Research
Volume 43, Issue 5p2, pages 1888–1905, October 2008
How to Cite
Conrad, D., Fishman, P., Grembowski, D., Ralston, J., Reid, R., Martin, D., Larson, E. and Anderson, M. (2008), Access Intervention in an Integrated, Prepaid Group Practice: Effects on Primary Care Physician Productivity. Health Services Research, 43: 1888–1905. doi: 10.1111/j.1475-6773.2008.00880.x
- Issue published online: 20 SEP 2008
- Article first published online: 25 JUL 2008
- integrated group practice
Objective. To estimate the joint effect of a multifaceted access intervention on primary care physician (PCP) productivity in a large, integrated prepaid group practice.
Data Sources. Administrative records of physician characteristics, compensation and full-time equivalent (FTE) data, linked to enrollee utilization and cost information.
Study Design. Dependent measures per quarter per FTE were office visits, work relative value units (WRVUs), WRVUs per visit, panel size, and total cost per member per quarter (PMPQ), for PCPs employed >0.25 FTE. General estimating equation regression models were included provider and enrollee characteristics.
Principal Findings. Panel size and RVUs per visit rose, while visits per FTE and PMPQ cost declined significantly between baseline and full implementation. Panel size rose and visits per FTE declined from baseline through rollout and full implementation. RVUs per visit and RVUs per FTE first declined, and then increased, for a significant net increase of RVUs per visit and an insignificant rise in RVUs per FTE between baseline and full implementation. PMPQ cost rose between baseline and rollout and then declined, for a significant overall decline between baseline and full implementation.
Conclusions. This organization-wide access intervention was associated with improvements in several dimensions in PCP productivity and gains in clinical efficiency.