Continuity of Care QPP Measures
Introducing continuity of care measures to the Quality Payment Program (QPP) may be the best route to lower healthcare costs and reduce hospitalizations according to a study recently published in the Annals of Family Medicine. Provider-level measures that support value-based payments by measuring true continuity of care have been lacking thus far in QPP. This led Dr. Andrew Bazemore to develop, and test 4 provider-level, claims-based continuity measures on over 1.4 million Medicare beneficiaries. The results showed providers with the highest level of continuity were 14.1% lower in cost than those in the lowest quintile. In addition to the cost savings, the odds of merely being hospitalized decreases 16.1% for providers with a high continuity of care score.
Researchers utilized four established measures, the Usual Provider Continuity (UPC) Index, Bice-Boxerman Continuity of Care, Modified Modified Continuity Index (MMCI), and the Herfindahl Index (HI) to then create an average across provider-level patient panels. The strong correlation between these continuity of care measurements and both clinical and fiscal outcomes, builds a strong case for supporting further focus on care continuity with providers and clinical teams. This may not be all that surprising to primary care providers, as a stronger patient relationship is often given credit for better care. However, this is a big win in terms of bridging the gap between a world of healthcare dominated by data and the real world of complex dynamics between patients, providers, and individual life circumstances.
The applicability and ease-of-reporting for these four measures is astounding in comparison to the barrage of primary-care centric measures currently in QPP. Researchers noted, “Primary care has the largest number of QPP measures but most of these are intermediate, disease-focused, and process measures, which risk driving primary care focus away from its core functions and real value.”
As value-based payments continue to snowball into effect, support for reasonable, applicable measures that bring minimal reporting burden is encouraged. To learn more, please see the Meaningful Measures Initiative here.