Higher Percentage of Virtual Primary Care Associated With Minimal Differences in Achievement of Quality Metrics
Bibliographic Data
| ID | 9099459 |
|---|---|
| Authors | Jodi B Segal (0000-0003-3978-9662, Johns Hopkins University, corresponding author), Lisa R Yanek (0000-0001-7117-1075, Johns Hopkins University, corresponding author), Lisa Yanek (Johns Hopkins University), Leah Jager (Johns Hopkins University), Leah R Jager (0000-0003-3362-2298, Johns Hopkins University), Ebele Okoli (Johns Hopkins University), Elham Hatef (0000-0003-2535-8191, Johns Hopkins University, corresponding author), Maqbool Dada (0000-0002-5256-1446, Johns Hopkins University), Kevin D Frick (0000-0002-0178-5319, Johns Hopkins University) |
| Year | 2025 |
| Volume | 63 |
| Issue | 1 |
| Pages | 70-76 |
| Publication date | 2025-01-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000002094 |
| PMID | 39531202 |
| OpenAlex | W4404262015 |
| Language | EN |
| References cited | 23 |
OBJECTIVE: To test the impact of virtual care usage on quality metrics used for performance measurement. BACKGROUND: Virtual care improves access to primary care; however, the quality of care must not be adversely impacted by its use. METHODS: This is a mixed-design etiologic study using data from patients receiving primary care in a large, regional health system from January 2020 through December 2021. Eligible patients had at least one primary care contact. Eligible physicians had 10 or more patient contacts. The quartile of virtual visits per physician per month is calculated as the percentage of total visits conducted by phone or video (Q1 is the lowest). Six metrics used for value-based reimbursement were chosen for modeling with generalized linear mixed models. RESULTS: The data included 200,090 patients of 683 physicians in 42 clinics over 24 months. Virtual care usage peaked in April 2020 at 78% and then stabilized at 18%. The blood pressure metric was met in 66% (95% CI: 63%-69%) of physician months in Q1 and 65% (95% CI: 63%-68%) in Q4 ( P = 0.003). The hemoglobin A1c metric was met in 73% (95% CI: 70%-76%) of physician months in Q1 and 72% (95% CI: 69%-75%) in Q4, not a significant difference. Breast cancer screening completion and colon cancer screening completion did not differ across virtual care quartiles. Medicare annual wellness visits were completed in 55% (95% CI: 50%-60%) of Q1 physician months and 54% in each of Q2, Q3, and Q4 ( P < 0.0001). CONCLUSIONS: Some quality metrics were modestly impacted by high virtual primary care usage; the absolute differences in rates were small. This may provide reassurance to physicians and their health systems that telemedicine use may not adversely impact quality metrics
Confidence interval · Family medicine · Health care · Metric (unit) · Primary care · Quartile · Reimbursement · Emergency Medicine · Internal Medicine · Medicine · Mobile Health and mHealth Applications · Primary Care and Health Outcomes · Telemedicine and Telehealth Implementation
| Citation velocity | historical |
|---|---|
| Highly cited | No |