Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.2754 Dr. Justin Markowski et al.
Points
- The study analyzed 684 FQHCs across 37 states and the District of Columbia, involving 17,823,959 patients in 2021, to assess the impact of Medicaid APMs on healthcare quality.
- The focus was on transitioning from traditional fee-for-service to value-based alternative payment models (APMs) between January 2013 and December 2021.
- Implementation of Medicaid APMs resulted in significant improvements in several healthcare quality measures, including increases in colorectal cancer screening, adult and child BMI assessments, and better control of hypertension and diabetes.
- The data indicated that FQHCs in states with Medicaid APMs showed notable improvements in process quality measures compared to those without these payment models, highlighting the effectiveness of APMs in enhancing healthcare outcomes.
- The findings support the viability of Medicaid APMs as a beneficial reimbursement model that raises clinical quality standards and contributes to the financial sustainability of health centers serving underserved communities, suggesting a positive direction for healthcare payment reforms.
Summary
In a comprehensive cohort study involving 684 federally qualified health centers (FQHCs) across 37 states and the District of Columbia, researchers assessed the impact of Medicaid alternative payment models (APMs) on the quality of care delivered. These FQHCs served 17,823,959 patients in 2021, with a significant female representation (57.3%). The study aimed to analyze the effect of the shift from traditional fee-for-service to value-based APMs, introduced between January 2013 and December 2021. The analysis focused on various healthcare quality measures such as cervical and colorectal cancer screenings, body mass index (BMI) assessments, and control of hypertension and diabetes.
The findings revealed that FQHCs in states implementing Medicaid APMs experienced notable improvements in several process quality measures compared to those without such models. Specifically, there were significant increases in colorectal cancer screening by 3.24 percentage points, adult BMI assessment by 3.19 percentage points, and child BMI assessment by 4.50 percentage points. Additionally, there were modest improvements in controlling blood pressure and blood glucose levels among patients with hypertension and type 2 diabetes, respectively, with an increase of 1.02 percentage points in each measure. These improvements highlight the potential effectiveness of APMs in enhancing healthcare outcomes.
The study concludes that the adoption of Medicaid APMs in FQHCs promotes higher standards of clinical quality and supports the financial sustainability of these centers. The data suggests that APMs are a viable and beneficial reimbursement model for health centers serving underserved communities, indicating a positive shift towards incentivizing quality care through structured payment reforms. This model could serve as a blueprint for further enhancing healthcare delivery in similar settings.
Link to the article: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2821079
References Markowski, J., Wallace, J., Schlesinger, M., & Ndumele, C. (2024). Alternative Payment Models and Performance in Federally Qualified Health Centers. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.2754
