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Staff Engagement in the Implementation of a Primary Care Value-Based Payment Program Increases Outpatient Care Utilization: A Mixed Methods Study.

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Title: Staff Engagement in the Implementation of a Primary Care Value-Based Payment Program Increases Outpatient Care Utilization: A Mixed Methods Study.
Authors: Ghosal, Ritu1 (AUTHOR) ritu.ghosal@providence.org, Kenton, Natalie Royal2 (AUTHOR), Holtorf, Megan1 (AUTHOR), Angus, Lisa1 (AUTHOR), Cohen-Cline, Hannah1 (AUTHOR)
Source: Inquiry (00469580). 10/27/2025, Vol. 62, p1-11. 11p.
Subject Terms: *Human services programs, *Research methodology, *Evaluation, Job involvement, Medical care use, Outpatient services in hospitals, Research funding, Primary health care, Value-based healthcare, Interviewing, Evaluation of medical care, Quantitative research, Descriptive statistics, Sound recordings, Thematic analysis, Data analysis software, Nosology
Abstract: This convergent parallel mixed-methods study examined how a primary care value-based payment (VBP) model affected patient health care use and captured implementation experiences from select clinics. Focusing on outpatient care as a key step to improving outcomes, we used a difference-in-differences model to compare outpatient utilization between PCPM (the VBP model) and non-PCPM clinics, and semi-structured interviews with a subset of participating clinics to explore implementation efforts on the ground. We identified our quantitative study population (cases N = 68 807; control N = 71 695) and outcomes from Oregon's All Payer All Claims (APAC) data system and, qualitatively, we conducted 12 interviews with operational/administrative staff at 7 PCPM clinics. Our findings indicated that PCPM patients experienced greater connection to primary and specialty care—both the proportion who used care and the average amount of care used per member—relative to the control group. Primary care use rose by 4.2 percentage points (95% CI: 3.3%, 5.1%; P <.001), and specialty care by 1.1 points (95% CI: 0.4%, 1.8%; P =.002). Among users, primary care visits increased by 136.9 per 1000 member months (95% CI: 107.2, 166.6; P <.001), and specialty care by 32.1 (95% CI: 10.5, 53.7; P =.004). Qualitative findings added further context: (1) staff communication about PCPM efforts connects directly to improvements in care delivery and patient outcomes; (2) success depends on care team staff being involved in the creation of new workflows and processes; and (3) access to program data helps to identify care gaps and improve patient care delivery. We concluded that care team staff engagement in VBP models is strengthened by making the connection between VBP and direct improvements to patient care. Models that motivate staff can lead to increased connection to primary and specialty care among the clinic's patient population. [ABSTRACT FROM AUTHOR]
Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Staff Engagement in the Implementation of a Primary Care Value-Based Payment Program Increases Outpatient Care Utilization: A Mixed Methods Study.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Inquiry+%2800469580%29%22&quot;&gt;Inquiry (00469580)&lt;/searchLink&gt;. 10/27/2025, Vol. 62, p1-11. 11p.
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  Label: Abstract
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  Data: This convergent parallel mixed-methods study examined how a primary care value-based payment (VBP) model affected patient health care use and captured implementation experiences from select clinics. Focusing on outpatient care as a key step to improving outcomes, we used a difference-in-differences model to compare outpatient utilization between PCPM (the VBP model) and non-PCPM clinics, and semi-structured interviews with a subset of participating clinics to explore implementation efforts on the ground. We identified our quantitative study population (cases N = 68 807; control N = 71 695) and outcomes from Oregon&#39;s All Payer All Claims (APAC) data system and, qualitatively, we conducted 12 interviews with operational/administrative staff at 7 PCPM clinics. Our findings indicated that PCPM patients experienced greater connection to primary and specialty care—both the proportion who used care and the average amount of care used per member—relative to the control group. Primary care use rose by 4.2 percentage points (95% CI: 3.3%, 5.1%; P &lt;.001), and specialty care by 1.1 points (95% CI: 0.4%, 1.8%; P =.002). Among users, primary care visits increased by 136.9 per 1000 member months (95% CI: 107.2, 166.6; P &lt;.001), and specialty care by 32.1 (95% CI: 10.5, 53.7; P =.004). Qualitative findings added further context: (1) staff communication about PCPM efforts connects directly to improvements in care delivery and patient outcomes; (2) success depends on care team staff being involved in the creation of new workflows and processes; and (3) access to program data helps to identify care gaps and improve patient care delivery. We concluded that care team staff engagement in VBP models is strengthened by making the connection between VBP and direct improvements to patient care. Models that motivate staff can lead to increased connection to primary and specialty care among the clinic&#39;s patient population. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1177/00469580251384760
    Languages:
      – Code: eng
        Text: English
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      Pagination:
        PageCount: 11
        StartPage: 1
    Subjects:
      – SubjectFull: Human services programs
        Type: general
      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Evaluation
        Type: general
      – SubjectFull: Job involvement
        Type: general
      – SubjectFull: Medical care use
        Type: general
      – SubjectFull: Outpatient services in hospitals
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Primary health care
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      – SubjectFull: Value-based healthcare
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      – SubjectFull: Interviewing
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      – SubjectFull: Evaluation of medical care
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      – SubjectFull: Sound recordings
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      – SubjectFull: Data analysis software
        Type: general
      – SubjectFull: Nosology
        Type: general
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      – TitleFull: Staff Engagement in the Implementation of a Primary Care Value-Based Payment Program Increases Outpatient Care Utilization: A Mixed Methods Study.
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              Text: 10/27/2025
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