Workforce Configurations to Provide High-Quality, Comprehensive Primary Care: a Mixed-Method Exploration of Staffing for Four Types of Primary Care Practices View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-07-03

AUTHORS

David Meyers, Lisa LeRoy, Michael Bailit, Judith Schaefer, Edward Wagner, Chunliu Zhan

ABSTRACT

BackgroundBroad consensus exists about the value and principles of primary care; however, little is known about the workforce configurations required to deliver it.ObjectiveThe aim of this study was to explore the team configurations and associated costs required to deliver high-quality, comprehensive primary care.MethodsWe used a mixed-method and consensus-building process to develop staffing models based on data from 73 exemplary practices, findings from 8 site visits, and input from an expert panel. We first defined high-quality, comprehensive primary care and explicated the specific functions needed to deliver it. We translated the functions into full-time-equivalent staffing requirements for a practice serving a panel of 10,000 adults and then revised the models to reflect the divergent needs of practices serving older adults, patients with higher social needs, and a rural community. Finally, we estimated the labor and overhead costs associated with each model.ResultsA primary care practice needs a mix of 37 team members, including 8 primary care providers (PCPs), at a cost of $45 per patient per month (PPPM), to provide comprehensive primary care to a panel of 10,000 actively managed adults. A practice requires a team of 52 staff (including 12 PCPs) at $64 PPPM to care for a panel of 10,000 adults with a high proportion of older patients, and 50 staff (with 10 PCPs) at $56 PPPM for a panel of 10,000 with high social needs. In rural areas, a practice needs 22 team members (with 4 PCPs) at $46 PPPM to serve a panel of 5000 adults.ConclusionsOur estimates provide health care decision-makers with needed guideposts for considering primary care staffing and financing and inform broader discussions on primary care innovations and the necessary resources to provide high-quality, comprehensive primary care in the USA. More... »

PAGES

1774-1779

References to SciGraph publications

  • 2017-02-27. The Coming Primary Care Revolution in JOURNAL OF GENERAL INTERNAL MEDICINE
  • 2007-01-09. Fundamental Reform of Payment for Adult Primary Care: Comprehensive Payment for Comprehensive Care in JOURNAL OF GENERAL INTERNAL MEDICINE
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    http://scigraph.springernature.com/pub.10.1007/s11606-018-4530-7

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    http://dx.doi.org/10.1007/s11606-018-4530-7

    DIMENSIONS

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    https://www.ncbi.nlm.nih.gov/pubmed/29971635


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