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Financial Impact of Universal Precepting in Family Medicine Residency Clinics.
Harper, Peter G; Adam, Patricia; Wooten, Mike; Smithson, Angela; Martin, Casey; Carlson, Samantha; Pattock, Andrew M; Satin, David J.
Afiliación
  • Harper PG; Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN.
  • Adam P; Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN.
  • Wooten M; Department of Family Medicine and Community Health,University of Minnesota Medical School, Minneapolis, MN.
  • Smithson A; Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN.
  • Martin C; Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN.
  • Carlson S; Department of Family Medicine and Community Health,University of Minnesota Medical School, Minneapolis, MN.
  • Pattock AM; Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN.
  • Satin DJ; Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN.
Fam Med ; 52(1): 24-30, 2020 01 04.
Article en En | MEDLINE | ID: mdl-31689356
BACKGROUND AND OBJECTIVES: Precepting methods have significant impact on the financial viability of family medicine residency programs. Following an adverse event, four University of Minnesota Family Medicine residency clinics moved from using Medicare's Primary Care Exception (PCE) and licensure precepting (LP) to a "universal precepting" method in which preceptors see every patient face to face. Variation in the implementation of universal precepting created a natural experiment of its financial impact. METHODS: Universal precepting was implemented in October 2013 across four residency programs. Billing codes were measured 1 year before and 2.5 years after implementation by clinic and residency year. RESULTS: There were significant financial differences between clinics based on original precepting method and implementation quality of universal precepting. The clinic moving from PCE to universal precepting with excellent implementation increased higher-level billing (99214) by 8%-10%. Clinics moving from LP demonstrated wide variation ranging from an 18% increase to a 13% decrease, consistent with the implementation quality. CONCLUSIONS: Clinics transitioning from PCE to universal precepting can see a significant increase in 99214 billing. Clinics transitioning from LP to universal precepting are at significant financial risk if poorly implemented, but may see increased 99214 billing with effective implementation. This suggests that both implementation quality and original precepting method impact 99214 billing rates when transitioning to universal precepting.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Preceptoría / Medicina Familiar y Comunitaria / Reclamos Administrativos en el Cuidado de la Salud / Internado y Residencia Tipo de estudio: Health_economic_evaluation Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Fam Med Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Preceptoría / Medicina Familiar y Comunitaria / Reclamos Administrativos en el Cuidado de la Salud / Internado y Residencia Tipo de estudio: Health_economic_evaluation Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Fam Med Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos