Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa, USA.
Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, USA.
Health Serv Res. 2022 Oct;57(5):1182-1190. doi: 10.1111/1475-6773.14030. Epub 2022 Jul 18.
To evaluate whether primary care physicians' participation in the Medicare Shared Savings Program (MSSP) is associated with changes in their preventive services delivery.
Medicare Provider Utilization and Payment Physician and Other Supplier Public Use File and MSSP Accountable Care Organizations (ACO) Provider-Level Research Identifiable File from 2012 to 2018.
The design was a two-way fixed effects model estimating within-provider changes in preventive services delivery over time controlling for provider time-invariant characteristics, national time trends, and characteristics of served patients. The following preventive services were evaluated: influenza vaccination, pneumococcal vaccination, clinical depression screening, colorectal cancer screening, breast cancer screening, Body Mass Index (BMI) screening and follow-up, tobacco use assessment, and annual wellness visits. Both the likelihood of providing services and the volume of services delivered were evaluated.
DATA COLLECTION/EXTRACTION METHODS: Secondary data linked at the provider level.
MSSP participation was associated with an increase in the likelihood of providing influenza vaccination (0.7 percentage-points), pneumococcal vaccination (2.0 percentage-points), clinical depression screening (2.1 percentage-points), tobacco use assessment (0.3 percentage-points), and annual wellness visits (4.1 percentage-points). A similar increase was found for the volume of services delivered per 100 patients for several preventive services: influenza vaccination (0.18), pneumococcal vaccination (0.56), clinical depression screening (0.46), and annual wellness visits (1.52). MSSP participation was associated with a decrease in the likelihood (-0.4 percentage-points) and the volume of colorectal cancer screening (-0.03).
Primary care physicians' participation in MSSP was associated with an increase in the likelihood and the volume of several preventive services.
评估初级保健医生参与医疗保险共享储蓄计划（MSSP）是否与他们提供预防服务的变化有关。
2012 年至 2018 年的医疗保险提供者利用和支付医师和其他供应商公共使用文件以及 MSSP 责任医疗组织（ACO）提供者级研究可识别文件。
该设计是一种双向固定效应模型，估计随着时间的推移，提供者内部提供预防服务的变化，同时控制提供者时间不变特征、国家时间趋势和服务对象的特征。评估了以下预防服务：流感疫苗接种、肺炎球菌疫苗接种、临床抑郁症筛查、结直肠癌筛查、乳腺癌筛查、体重指数（BMI）筛查和随访、烟草使用评估以及年度健康访视。评估了提供服务的可能性和提供服务的数量。
数据收集/提取方法：在提供者层面进行二级数据链接。
MSSP 参与与提供流感疫苗接种（0.7 个百分点）、肺炎球菌疫苗接种（2.0 个百分点）、临床抑郁症筛查（2.1 个百分点）、烟草使用评估（0.3 个百分点）和年度健康访视（4.1 个百分点）的可能性增加有关。还发现，每 100 名患者接受几种预防服务的服务量也有所增加：流感疫苗接种（0.18）、肺炎球菌疫苗接种（0.56）、临床抑郁症筛查（0.46）和年度健康访视（1.52）。MSSP 参与与结直肠癌筛查的可能性（-0.4 个百分点）和数量（-0.03）降低有关。
初级保健医生参与 MSSP 与增加几种预防服务的可能性和数量有关。
