Volume 49 | Number 1 | February 2014

Abstract List

Diane R. Rittenhouse, Laura A. Schmidt, Kevin J. Wu, James Wiley


To evaluate safety‐net clinics’ responses to a novel community‐wide Patient‐Centered Medical Home () financial incentive program in post‐Katrina New Orleans.

Data Sources/Study Setting

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.

Study Design

Multiwave, longitudinal, observational study of a local safety‐net primary care system.

Data Collection

Clinic‐level data from a semiannual survey of clinic leaders (89.3 percent response rate), augmented by administrative records.

Principal Findings

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.