Rachel Shapiro
Mathematica Policy Research
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Annals of Family Medicine | 2014
Deborah Peikes; Robert J. Reid; Timothy J. Day; Derekh D.F. Cornwell; Stacy Berg Dale; Richard J. Baron; Randall S. Brown; Rachel Shapiro
PURPOSE Despite growing calls for team-based care, the current staff composition of primary care practices is unknown. We describe staffing patterns for primary care practices in the Centers for Medicare and Medicaid Services (CMS) Comprehensive Primary Care (CPC) initiative. METHODS We undertook a descriptive analysis of CPC initiative practices’ baseline staffing using data from initial applications and a practice survey. CMS selected 502 primary care practices (from 987 applicants) in 7 regions based on their health information technology, number of patients covered by participating payers, and other factors; 496 practices were included in this analysis. RESULTS Consistent with the national distribution, most of the CPC initiative practices included in this study were small: 44% reported 2 or fewer full-time equivalent (FTE) physicians; 27% reported more than 4. Nearly all reported administrative staff (98%) and medical assistants (89%). Fifty-three percent reported having nurse practitioners or physician assistants; 47%, licensed practical or vocational nurses; 36%, registered nurses; and 24%, care managers/coordinators—all of these positions are more common in larger practices. Other clinical staff were reported infrequently regardless of practice size. Compared with other CPC initiative practices, designated patient-centered medical homes were more likely to have care managers/coordinators but otherwise had similar staff types. Larger practices had fewer FTE staff per physician. CONCLUSIONS At baseline, most CPC initiative practices used traditional staffing models and did not report having dedicated staff who may be integral to new primary care models, such as care coordinators, health educators, behavioral health specialists, and pharmacists. Without such staff and payment for their services, practices are unlikely to deliver comprehensive, coordinated, and accessible care to patients at a sustainable cost.
Mathematica Policy Research Reports | 2011
Lorenzo Moreno; Arnold Chen; Rachel Shapiro; Stacy Berg Dale
This book chapter looks at the CMS-funded Informatics for Diabetes Education and Telemedicine demonstration. The chapter summarizes participants’ use of the technology, intervention effects on intermediate clinical outcomes, intervention effects on Medicare services’ use and cost, and demonstration costs during the two phases. It also discusses policy implications of the findings in the context of health reform, particularly the potential role of home telemedicine in Medicare.
Health Care Financing Review | 2008
Dominick Esposito; Randall T Brown; Arnold Chen; Jennifer Schore; Rachel Shapiro
Mathematica Policy Research Reports | 2008
Arnold Chen; Randall S. Brown; Dominick Esposito; Jennifer Schore; Rachel Shapiro
Mathematica Policy Research Reports | 2015
Erin Fries Taylor; Stacy Berg Dale; Deborah Peikes; Randall S. Brown; Arkadipta Ghosh; Jesse C. Crosson; Grace Anglin; Rosalind Keith; Rachel Shapiro
Health Care Financing Review | 2009
Suzanne Felt-Lisk; Lorraine Johnson; Christopher Fleming; Rachel Shapiro; Brenda Natzke
Archive | 2008
Myles Maxfield; Deborah Peikes; Rachel Shapiro; Hongmai Pham; Sarah Hudson Scholle; Phyllis Torda
Mathematica Policy Research Reports | 2005
Leslie Foster; Randall S. Brown; Rachel Shapiro
Mathematica Policy Research Reports | 2013
Susan Zief; Rachel Shapiro; Debra A. Strong
Mathematica Policy Research Reports | 2014
Susan Zief; Rachel Shapiro; Debra A. Strong