To evaluate safety‐net clinics’ responses to a novel community‐wide Patient‐Centered Medical Home () financial incentive program in post‐Katrina New Orleans.
Between une 2008 and une 2010, we studied 50 primary care clinics in New Orleans receiving federal funds to expand services and improve care delivery.
Multiwave, longitudinal, observational study of a local safety‐net primary care system.
Clinic‐level data from a semiannual survey of clinic leaders (89.3 percent response rate), augmented by administrative records.
Overall, 62 percent of the clinics responded to financial incentives by achieving recognition from the National Committee on Quality Assurance (). Higher patient volume, higher baseline scores, and type of ownership were significant predictors of achieving recognition. The steepest increase in adoption of processes occurred among clinics achieving the highest, Level 3, recognition. Following recognition, 88.9 percent stabilized or increased their use of processes, although several specific processes had very low rates of adoption overall.
Findings demonstrate that widespread implementation is possible in a safety‐net environment when external financial incentives are aligned with the goal of practice innovation.
Data Sources/Study Setting