Primary Care

The entry point into the health system for most individuals, through a provider that delivers non-specialized, continuous, and coordinated care.

How Primary Care Provider Communication With Team Relates To Patients’ Disease Management

Ingrid Nembhard, PhD, MS, Associate Professor at the University of Pennsylvania's Wharton School
Jul. 1, 2020

 Yuna S.H. Lee, Marissa D. King, Daren Anderson, Paul D. Cleary, Ingrid M. Nembhard

Abstract [from journal]

Background: Investigating primary care provider (PCP)-team communication can provide insight into how colleagues work together to become high-functioning teams more able to address an increasingly complex set of tasks associated with chronic disease management.

Objective: To assess how PCP communication with their care team relates to patients’ health.

Research Design: Longitudinal study of how 3

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The Influence Of Medicare for All On Reimbursement For Emergency Care Treat-and-Release Visits

May. 24, 2020

Alexander Pomerantz, Ryan Burke, Ari Friedman, Laura Burke, Richard Wolfe, Peter Smulowitz

Abstract [from journal]

Study objective: Single-payer health care is supported by most Americans, but the effect of single payer on any particular sector of the health care market has not been well explored. We examine the effect of 2 potential single-payer designs, Medicare for All and an alternative including Medicare and Medicaid, on total payments and out-of-pocket spending for treat-and-release emergency care (patients discharged after an emergency department [ED] visit).

Methods: We used the 2013 to 2016 Medical

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Telephone Triage In Pediatric Head Injury: Follow-up Patterns And Subsequent Diagnosis Of Concussion

May. 22, 2020

Catherine C McDonald, Melissa R Pfeiffer, Roni L Robinson, Kristy B Arbogast, Christina L Master

Abstract [from journal]

Head injuries in childhood can result in concussion. Families of a child with a head injury often seek medical advice through telephone triage call systems. It is important to understand if patients follow telephone triage recommendations and what proportion of triage calls result in subsequent concussion diagnosis. We used a one-year retrospective cohort of triage calls screened with the Barton Schmitt Pediatric Head Injury Telephone Triage Protocol. The objectives were to estimate the proportion who followed up with urgent recommendations...

Phenotyping Physician Practice Patterns And Associations With Response To A Nudge In The Electronic Health Record For Influenza Vaccination: A Quasi-Experimental Study

May. 20, 2020

Sujatha Changolkar, Jeffrey Rewley, Mohan Balachandran, Charles A L Rareshide, Christopher K Snider, Susan C Day, Mitesh S Patel

Abstract [from journal]

Background: Health systems routinely implement changes to the design of electronic health records (EHRs). Physician behavior may vary in response and methods to identify this variation could help to inform future interventions. The objective of this study was to phenotype primary care physician practice patterns and evaluate associations with response to an EHR nudge for influenza vaccination.

Methods and findings: During the 2016-2017 influenza season, 3 primary care practices at Penn Medicine...

Do Incentive Payments Improve Home-Based Primary Care?

Feb. 4, 2020

After five years, a small experiment to improve care for frail elderly patients receiving primary care at home has delivered some savings to Medicare—although it might be too small to know for sure. Authorized by the Affordable Care Act, the Independence at Home (IAH) Demonstration is part of a broader strategy of testing innovative ways to pay for value in health care—tying additional payment to higher quality care and cutting wasteful spending.

Opportunities and Challenges for Previsit Screening for Sexual and Gender Identity Among Adolescents in Primary Care

Feb. 1, 2020

Jamie E. MehringerNadia L. Dowshen

Abstract [from journal]

Many sexual minority youth are at higher risk for poor health outcomes because of stigma, shame, and discrimination they may face because of their identity. Professional guidelines, including the American Academy of Pediatrics' Bright Futures, encourage discussion of sexual attraction and behavior in adolescent health supervision visits so that clinicians can support healthy adolescent sexual development, assure that the health needs of youth of all sexual identities are met, and facilitate family acceptance and support of youth when needed...

Health Care Safety-Net Programs After The Affordable Care Act

Issue Brief
Oct. 1, 2019

Prior to the Affordable Care Act (ACA), health care safety-net programs were the primary source of care for over 44 million uninsured people. While the ACA cut the number of uninsured substantially, about 30 million people remain uninsured, and many millions more are vulnerable to out-of-pocket costs beyond their resources. The need for the safety net remains, even as the distribution and types of need have shifted. This brief reviews the effects of the ACA on the funding and operation of safety-net institutions. It highlights the challenges and opportunities that health care reform presents to safety-net programs, and how they have adapted and evolved to continue to serve our most vulnerable residents.

Fast-tracking Behavioral Health Care

Sep. 17, 2019

Imagine struggling with a behavioral health issue, searching for a local psychiatrist, and finding out the provider you’ve chosen doesn’t accept insurance. You wouldn’t be alone: most psychiatrists in the United States don’t. But let’s say your plan has some out-of-network benefits, which means you pay the full cost up front and request an itemized receipt for every appointment.

Primary Care Appointments for Medicaid Beneficiaries With Advanced Practitioners

Jul. 1, 2019

Lena Leszinsky, Molly Candon

Abstract [from journal]

Primary care access in Medicaid improved after the Patient Protection and Affordable Care Act despite millions of new beneficiaries. One possible explanation is that practices are scheduling more appointments with advanced practitioners. To test this theory, we used data from a secret shopper study in which callers simulated new Medicaid patients and requested appointments with 3,742 randomly selected primary care practices in 10 states. Conditional on scheduling an appointment, simulated patients asked whether the practitioner...

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