Development and Testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey

Derrett, Sarah; Gunter, Kathryn E.; Samaranayaka, Ari; Singer, Sara J.; Nocon, Robert S.; Quinn, Michael T.; Breheny, Mary; Campbell, Amanda; Schaefer, Cynthia T.; Heuer, Loretta; Chin, Marshall H.

doi:10.1177/1077558717745936

Cited by 9 publications

(7 citation statements)

References 29 publications

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“…The questionnaire used for the survey will incorporate the previously validated measures of perceptions of care integration from the Provider and Staff Perceptions of Integrated Care (PSPICs) ( 33 ) and new questions developed and pilot tested by the research team to address specific aspects of implementation of the DSRIP program. CFIR domains explored will include Inner Setting (care coordination within the practice site and with external providers and community resources); Outer Setting (patient engagement, MassHealth policies and processes, payment and financial incentives) and Processes (practice site structures and processes).…”

Section: Methods and Analysismentioning

confidence: 99%

Barriers and Facilitators to Implementation of Value-Based Care Models in New Medicaid Accountable Care Organizations in Massachusetts: A Study Protocol

Goff

Gurewich

Alcusky

et al. 2021

Front. Public Health

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Introduction: Massachusetts established 17 new Medicaid accountable care organizations (ACOs) and 24 affiliated Community Partners (CPs) in 2018 as part of a large-scale healthcare reform effort to improve care value. The new ACOs will receive $1.8 billion dollars in state and federal funding over 5 years through the Delivery System Reform Incentive Program (DSRIP). The multi-faceted study described in this protocol aims to address gaps in knowledge about Medicaid ACOs' impact on healthcare value by identifying barriers and facilitators to implementation and sustainment of the DSRIP-funded programs.Methods and analysis: The study's four components are: (1) Document Review to characterize the ACOs and CPs; (2) Semi-structured Key Informant Interviews (KII) with ACO and CP leadership, state-level Medicaid administrators, and patients; (3) Site visits with selected ACOs and CPs; and (4) Surveys of ACO clinical teams and CP staff. The Consolidated Framework for Implementation Research's (CFIR) serves as the study's conceptual framework; its versatile menu of constructs, arranged across five domains (Intervention Characteristics, Inner Setting, Outer Setting, Characteristics of Individuals, and Processes) guides identification of barriers and facilitators across multiple organizational contexts. For example, KII interview guides focus on understanding how Inner and Outer Setting factors may impact implementation. Document Review analysis includes extraction and synthesis of ACO-specific DSRIP-funded programs (i.e., Intervention Characteristics); KIIs and site visit data will be qualitatively analyzed using thematic analytic techniques; surveys will be analyzed using descriptive statistics (e.g., counts, frequencies, means, and standard deviations).Discussion: Understanding barriers and facilitators to implementing and sustaining Medicaid ACOs with varied organizational structures will provide critical context for understanding the overall impact of the Medicaid ACO experiment in Massachusetts. It will also provide important insights for other states considering the ACO model for their Medicaid programs.Ethics and dissemination: IRB determinations were that the overall study did not constitute human subjects research and that each phase of primary data collection should be submitted for IRB review and approval. Study results will be disseminated through traditional channels such as peer reviewed journals, through publicly available reports on the mass.gov website; and directly to key stakeholders in ACO and CP leadership.

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Section: Methods and Analysismentioning

confidence: 99%

Barriers and Facilitators to Implementation of Value-Based Care Models in New Medicaid Accountable Care Organizations in Massachusetts: A Study Protocol

Goff

Gurewich

Alcusky

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…Survey items were informed by a review of the literature and by interviews with subject matter experts and representatives of CHCs and state primary care associations, which provide training and technical assistance to safety-net providers. We used items from existing surveys when possible (15)(16)(17). We obtained comments on the draft survey from primary care associations.…”

Section: Conceptual Modelmentioning

confidence: 99%

Association of Primary and Specialty Care Integration on Physician Communication and Cancer Screening in Safety-Net Clinics

et al. 2020

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What is already known on this topic? Community health centers (CHCs) provide primary care to disadvantaged populations and have lower-than-average cancer screening rates. Stronger integration of CHCs and specialists is recommended to increase cancer screening, but the impact of integration efforts in the real world is unknown. What is added by this report? CHCs that are more strongly integrated with specialists have higher rates of cervical and colorectal cancer screening and better communication with specialists compared with the least integrated CHCs. What are the implications for public health practice? Integration between CHCs and specialists may enhance communication across health care providers and improve cancer screening rates. Efforts are needed to promote integration and identify the mechanisms that lead to long-term, effective partnerships.

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“…The questionnaire used for the survey will incorporate the previously validated measures of perceptions of care integration from the Provider and Staff Perceptions of Integrated Care (PSPICs) (19) and new questions developed and pilot tested by the investigative team to address speci c aspects of implementation of the DSRIP program. CFIR domains explored will include Inner Setting (care coordination within the practice site and with external providers and community resources); Outer Setting (patient engagement, MassHealth policies and processes, payment and nancial incentives) and Processes (practice site structures and processes).…”

Section: Questionnaire Developmentmentioning

confidence: 99%

Barriers and Facilitators To Implementation and Sustainment of 17 New Medicaid Accountable Care Organizations in Massachusetts: A Study Protocol

Goff

Gurewich

Alcusky

et al. 2020

Preprint

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Background: Accountable care organizations (ACOs) utilize value-based payment models, which incentivize quality of care and cost reduction through shared financial risk contracts for payers and providers. The impact of ACOs on cost and quality has been mixed for Medicare and commercial insurers, but the model has yet to be extensively tested in the Medicaid system, which insures a large number of patients in socioeconomically disadvantaged populations. Additionally, despite substantial heterogeneity in ACO models, the majority of ACO studies have examined ACO outcomes without exploring the potential impact of implementation and sustainment on these outcomes. Understanding barriers and facilitators to implementation and sustainment of Medicaid ACOs will help to better understand their impact on patient care, outcomes and costs for a vulnerable population.Methods and Design: The state of Massachusetts (MA) approved 17 new Medicaid ACOs and associated Community Partner (CP) organizations in 2018 as part of a large-scale pragmatic experiment in healthcare reform. The new ACOs will receive $1.8 billion dollars in state and federal funds over five years aimed at supporting implementation and sustainment the new model. This study aims to identify barriers and facilitators to implementation and sustainment of activities supported by these funds using the Consolidated Framework for Implementation Science (CFIR) as a guiding framework through: (1) review of administrative documents classify organizational characteristics of the ACOs and CPs including plans for innovation; (2) key informant interviews (KII) with ACO and CP leaders, governmental administrative leaders, and patients; (3) case studies of ACOs and CPs; and (4) a survey of front-line providers and staff in the ACOs and CPs. Descriptive quantitative statistics will be used to analyze document and survey data and framework analysis will be used to analyze KII and site visit data.Discussion: The new Medicaid ACOs in MA aim to improve care integration, quality of care, and patient experience while reducing costs through innovations in healthcare delivery and payment. Understanding the barriers and facilitators to implementing and sustaining the ACO model will provide critical context for understanding the overall impact of the Medicaid ACO experiment in MA.

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Development and Testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey

Cited by 9 publications

References 29 publications

Barriers and Facilitators to Implementation of Value-Based Care Models in New Medicaid Accountable Care Organizations in Massachusetts: A Study Protocol

Barriers and Facilitators to Implementation of Value-Based Care Models in New Medicaid Accountable Care Organizations in Massachusetts: A Study Protocol

Association of Primary and Specialty Care Integration on Physician Communication and Cancer Screening in Safety-Net Clinics

Barriers and Facilitators To Implementation and Sustainment of 17 New Medicaid Accountable Care Organizations in Massachusetts: A Study Protocol

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