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Comparing Shared Patient Networks Across Payers.

ABSTRACT: BACKGROUND:Measuring care coordination in administrative data facilitates important research to improve care quality. OBJECTIVE:To compare shared patient networks constructed from administrative claims data across multiple payers. DESIGN:Social network analysis of pooled cross sections of physicians treating prevalent colorectal cancer patients between 2003 and 2013. PARTICIPANTS:Surgeons, medical oncologists, and radiation oncologists identified from North Carolina Central Cancer Registry data linked to Medicare claims (N?=?1735) and private insurance claims (N?=?1321). MAIN MEASURES:Provider-level measures included the number of patients treated, the number of providers with whom they share patients (by specialty), the extent of patient sharing with each specialty, and network centrality. Network-level measures included the number of providers and shared patients, the density of shared-patient relationships among providers, and the size and composition of clusters of providers with a high level of patient sharing. RESULTS:For 24.5% of providers, total patient volume rank differed by at least one quintile group between payers. Medicare claims missed 14.6% of all shared patient relationships between providers, but captured a greater number of patient-sharing relationships per provider compared with the private insurance database, even after controlling for the total number of patients (27.242 vs 26.044, p?

SUBMITTER: Trogdon JG

PROVIDER: S-EPMC6816773 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Comparing Shared Patient Networks Across Payers.

Trogdon Justin G JG Weir W H WH Shai S S Mucha P J PJ Kuo T M TM Meyer A M AM Stitzenberg K B KB

Journal of general internal medicine 20190403 10

<h4>Background</h4>Measuring care coordination in administrative data facilitates important research to improve care quality.<h4>Objective</h4>To compare shared patient networks constructed from administrative claims data across multiple payers.<h4>Design</h4>Social network analysis of pooled cross sections of physicians treating prevalent colorectal cancer patients between 2003 and 2013.<h4>Participants</h4>Surgeons, medical oncologists, and radiation oncologists identified from North Carolina ...[more]

PMID: 30945065

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Project description:BackgroundShared medical appointments (SMAs) have been shown to be an efficient and effective strategy for providing diabetes self-management education and self-management support. SMA features vary and it is not known which features are most effective for different patients and practice settings. The Invested in Diabetes study tests the comparative effectiveness of SMAs with and without multidisciplinary care teams and patient topic choice for improving patient-centered and clinical outcomes related to diabetes.MethodsThis study compares the effectiveness of two SMA approaches using the Targeted Training for Illness Management (TTIM) curriculum. Standardized SMAs are led by a health educator with a set order of TTIM topics. Patient-driven SMAs are delivered collaboratively by a multidisciplinary care team (health educator, medical provider, behavioral health provider, and a peer mentor); patients select the order and emphasis on TTIM topics. Invested in Diabetes is a cluster randomized pragmatic trial involving approximately 1440 adult patients with type 2 diabetes. Twenty primary care practices will be randomly assigned to either standardized or patient-driven SMAs. A mixed-methods evaluation will include quantitative (practice- and patient-level data) and qualitative (practice and patient interviews, observation) components. The primary patient-centered outcome is diabetes distress. Secondary outcomes include autonomy support, self-management behaviors, clinical outcomes, patient reach, and practice-level value and sustainability.DiscussionPractice and patient stakeholder input guided protocol development for this pragmatic trial comparing SMA approaches. Implementation strategies from the enhanced Replicating Effective Programs framework will help ensure practices maintain fidelity to intervention protocols while tailoring workflows to their settings. Invested in Diabetes will contribute to the literature on chronic illness management and implementation science using the RE-AIM model.Trial registrationClinicalTrials.gov, NCT03590041. Registered on 5 July 2018.

Dataset Information

Comparing Shared Patient Networks Across Payers.

Publications

Comparing Shared Patient Networks Across Payers.

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