CEO & President, Daughters of Charity Services of New Orleans

Dissertation Title

Impact of NCQA PCMH-Level on Low Income Diabetics in Louisiana

Dissertation Abstract

While past studies have examined the relationship between safety-net provider sites that are certified as Patient Centered Medical Homes (PCMH) and quality health care outcomes, no previous studies have evaluated the relationship between NCQA PCMH certification levels at primary care sites and quality health care outcomes. NCQA is the largest national certification program for PCMH, and for 10 years was the only national program that offered a tiered level of certification based on provider level of patient engagement and deployed resources. The Donabedian Model, which focuses on structure, process, and outcomes, was used to develop the theoretical framework to address two primary hypothesis. Secondary data from two sets of primary care providers participating in the Beacon Community grant in New Orleans and the Health Center Control Network of the Louisiana Primary Care Association both reported quarterly data that were used to test the hypothesized relationships of pooled cross-sectional panel data using the Hausman-Taylor estimator regression models. The data utilized were from 47 practice sites over a five-year period from 2011-2014. Diabetes and Hypertension HEDIS measures were utilized as the dependent variable in the evaluation of improved health care quality.

This study did not find a significant relationship between having NCQA PCMH status and improved quality using diabetes and hypertension HEDIS measures, nor did the study find a significant relationship between higher NCQA PCMH certification level and increased quality. One finding that was observed was improved quality over time in going to the NCQA PCMH.

Findings for this study are useful to physician practices, provider organizations, policymakers and payers to extend and increase their knowledge for NCQA PCMH certification and its relationship to quality. The results may also influence funders and financial support from entities like HRSA which incentivize adopting PCMH programs.