Practice Transformation in the Transforming Clinical Practice Initiative and Emergency Department Use

Ann Fam Med. 2024 Jul-Aug;22(4):325-328. doi: 10.1370/afm.3119.

Abstract

To provide insight on how ambulatory care practices can reduce emergency department (ED) visits, we studied changes in Medicare ED visits for primary and specialty care practices in the Transforming Clinical Practice Initiative. We compared practices that transformed more vs less during the 6-year period ending in 2021 (3,773 practices). Using data from a practice transformation assessment tool completed at multiple intervals, we found improvement in the transformation score was associated with reduced ED visits by 6% and 4% for primary and specialty care practices, respectively, 3 to 4 years after first assessment. Transformation in 5 of 8 domains contributed to reduced ED visits.

Keywords: Medicare; ambulatory care; emergency department; practice transformation.

MeSH terms

  • Ambulatory Care / statistics & numerical data
  • Emergency Service, Hospital* / statistics & numerical data
  • Humans
  • Medicare* / statistics & numerical data
  • Organizational Innovation
  • Primary Health Care* / organization & administration
  • Quality Improvement
  • United States