Montpelier, VT, USA: Vermont Program for Quality in Health Care.
Vermont Program for Quality in Health Care, Montpelier, VT, USA
OBJECTIVE: The objective of the FQHC study is to assess the efficacy of the Community Health Center (CHC) Model for Medicaid beneficiaries in Vermont. The study seeks to answer the question of whether healthcare utilization patterns and outcomes are different for PC Plus beneficiaries with a community health center (FQHC/RHC) as their “medical home”. A beneficiary’s medical home is the location where at least 50% of their care was obtained.
DATA SOURCE AND SETTING: Electronic Data Systems (EDS) administrative claims for paid and delivered services (medical and pharmaceutical) are annualized into the 2002 through 2004 VPQ Medicaid database system.
DESIGN AND METHODS: The FQHC study is a quasi-experimental longitudinal retrospective design looking at patient demographics and service utilization using Medicaid paid claims for calendar years 2002 through 2004. Analyses will be conducted for beneficiaries in the PC Plus program receiving over 50% of their preventative and primary care services from FQHCs/RHCs and PC Plus beneficiaries receiving similar services primarily within “other” private clinical practice settings.
PRINCIPAL FINDINGS: In each year of the study, approximately 30,000 patients received care from the three FQHC sites. Roughly one-third of all patients were covered by Medicaid. Approximately two-thirds of all Vermont Medicaid beneficiaries are enrolled in the PC Plus program, accounting for over 90,000 individuals for each the 2002 through 2004 calendar years. Sixty percent of clients were female. Resource and service utilization were similar for each medical home location.
CONCLUSIONS: The number of beneficiaries enrolled in the FQHC!RHC sites is small and prevents adequate comparison to beneficiaries who receive the majority of their care in other locations. Several plausible explanations include Medicaid clients utilizing pediatrician private practices and a significant number of individuals may have either dual Medicaid and Medicare or Medicare coverage. Thus, to fully assess the efficacy of the FQHCs in Vermont, access to Medicare and other commercial insurance claims are needed.