Staffing patterns of primary care practices in the Comprehensive Primary Care initiative.

Authors, Primary Peikes,Deborah N.;Reid,Robert J.;Day,Timothy J.;Cornwell,Derekh D. F.;Dale,Stacy B.;Baron,Richard J.;Brown,Randall S.;Shapiro,Rachel J.
Title Primary Staffing patterns of primary care practices in the Comprehensive Primary Care initiative.
Periodical Full Annals of Family Medicine
Pub Year 1969
Volume 12
issue 2
Start Page 142-149
Abstract Purpose: Despite growing calls for team-based care, the current staff composition of primary care practices is unknown. We describe staffing patterns for primary care practices in the Centers for Medicare and Medicaid Services (CMS) Comprehensive Primary Care (CPC) initiative. Methods: We undertook a descriptive analysis of CPC initiative practices' baseline staffing using data from initial applications and a practice survey. CMS selected 502 primary care practices (from 987 applicants) in 7 regions based on their health information technology, number of patients covered by participating payers, and other factors; 495 practices were included in this analysis. Results: Consistent with the national distribution, most of the CPC initiative practices included in this study were small: 44% reported 2 or fewer full-time equivalent (FTE) physicians; 27% reported more than 4. Nearly all reported administrative staff (98%) and medical assistants (89%). Fifty-three percent reported having nurse practitioners or physician assistants; 47%, licensed practical or vocational nurses; 36%, registered nurses; and 24%, care managers/coordinators-all of these positions are more common in larger practices. Other clinical staff were reported infrequently regardless of practice size. Compared with other CPC initiative practices, designated patient-centered medical homes were more likely to have care managers/coordinators but otherwise had similar staff types. Larger practices had fewer FTE staff per physician. Conclusions: At baseline, most CPC initiative practices used traditional staffing models and did not report having dedicated staff who may be integral to new primary care models, such as care coordinators, health educators, behavioral health specialists, and pharmacists. Without such staff and payment for their services, practices are unlikely to deliver comprehensive, coordinated, and accessible care to patients at a sustainable cost. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)
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Author/Address Peikes, Deborah N.:
PubMed Link
Reference Type(s) Journal Article
Topic Tag(s) Comprehensive Care;Care Coordination;Primary Care Workforce Issues;Demonstrations;Team Based Health Care
Special Population(s) Not Available
Case Study No
Commentary/Opinion Piece No
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