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The Impact of a Health Information Technology–Focused Patient-centered Medical Neighborhood Program Among Medicare Beneficiaries in Primary Care Practices

The Effect on Patient Outcomes and Spending

Orzol, Sean PhD*; Keith, Rosalind PhD*; Hossain, Mynti MPP*; Barna, Michael MA*; Peterson, G. Greg PhD*; Day, Timothy MSHP; Gilman, Boyd PhD*; Blue, Laura PhD*; Kranker, Keith PhD*; Stewart, Kate A. PhD*; Hoag, Sheila MA*; Moreno, Lorenzo PhD*

doi: 10.1097/MLR.0000000000000880
Original Articles

Background: The Center for Medicare & Medicaid Innovation (CMMI) tests new models of paying for or delivering health care services and expands models that improve health outcomes while lowering medical spending. CMMI gave TransforMED, a national learning and dissemination contractor, a 3-year Health Care Innovation Award (HCIA) to integrate health information technology systems into physician practices. This paper estimates impacts of TransforMED’s HCIA-funded program on patient outcomes and Medicare parts A and B spending.

Research Design: We compared outcomes for Medicare fee-for-service (FFS) beneficiaries served by 87 treatment practices to outcomes for Medicare FFS beneficiaries served by 286 matched comparison practices, adjusting for differences in outcomes between the 2 groups during a 1-year baseline period. We estimated impacts in 3 evaluation outcome domains: quality-of-care processes, service use, and spending.

Results: We estimated the program led to a 7.1% reduction in inpatient admissions and a 5.7% decrease in the outpatient emergency department visits. However, there was no evidence of statistically significant effects in outcomes in either the quality-of-care processes or spending domains.

Conclusions: These results indicate that TransforMED’s program reduced service use for Medicare FFS beneficiaries, but also show that the program did not have statistically significant favorable impacts in the quality-of-care processes or spending domains. These results suggest that providing practices with population health management and cost-reporting software—along with technical assistance for how to use them—can complement practices’ own patient-centered medical home transformation efforts and add meaningfully to their impacts on service use.

*Mathematica Policy Research, Princeton, NJ

Centers for Medicare & Medicaid Services, Baltimore, Maryland

Supported by the Centers for Medicare & Medicaid Services, Center for Medicare & Medicaid Innovation, contract number HHSM-500-2010-000261/HHSM-500-T0015. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the US Department of Health and Human Services or any of its agencies.

The authors declare no conflict of interest.

Reprints: Sean Orzol, PhD, 220 E. Huron Street, Suite 300, Ann Arbor, MI 48104. E-mail:

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