Skip to main content

Main menu

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers

User menu

  • My alerts

Search

  • Advanced search
Annals of Family Medicine
  • My alerts
Annals of Family Medicine

Advanced Search

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers
  • Follow annalsfm on Twitter
  • Visit annalsfm on Facebook
Research ArticleOriginal Research

Cost Estimates for Operating a Primary Care Practice Facilitation Program

Steven D. Culler, Michael L. Parchman, Raquel Lozano-Romero, Polly H. Noel, Holly J. Lanham, Luci K. Leykum and John E. Zeber
The Annals of Family Medicine May 2013, 11 (3) 207-211; DOI: https://doi.org/10.1370/afm.1496
Steven D. Culler
1Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta Georgia
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: sculler@emory.edu
Michael L. Parchman
2MacColl Center for Health Care Innovation Group Health Research Institute, Group Health Cooperative, Seattle, Washington
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Raquel Lozano-Romero
3Department of Family & Community Medicine, University of Texas Health Science Center-San Antonio, San Antonio, Texas
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Polly H. Noel
4Department of Medicine, University of Texas Health Science Center-San Antonio, San Antonio, Texas
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Holly J. Lanham
4Department of Medicine, University of Texas Health Science Center-San Antonio, San Antonio, Texas
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Luci K. Leykum
4Department of Medicine, University of Texas Health Science Center-San Antonio, San Antonio, Texas
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John E. Zeber
5Scott & White Healthcare, Center for Applied Health Research, Temple, Texas
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Tables

  • Additional Files
    • View popup
    Table 1

    Selected Baseline Characteristics of Clinical Practices Receiving Practice Facilitation Activities (N = 19 practices)

    CharacteristicMean (SD)MedianRange
    FTE personnel, No.
     Physicians, medical and osteopathic1.05 (0.22)1.01–2
     Physicians assistants0.31 (0.58)0.00–1
     Nurse practitioners0.11 (0.31)00–1
     Office staff6.1 (2.4)52–12
    Health information technology, %
     Electronic patient scheduling94.7––
     Electronic clinical patient management63.2––
     Electronic prescribing31.6––
     Electronic referral request submission31.6––
    Patient volume per clinician
     Office visits per day per FTE clinician, No.24.0 (4.9)2518–35
     Hospital visits per week, No.4.08 (7.39)00–25
     Practice routinely measures patient satisfaction, %21.2––
    Patient insurance status, No.
     Medicare30.5 (22.9)250–80
     Medicaid14.5 (20.1)50–80
     Capitation9.6 (17.0)00–48
     Fee for service33.4 (31.1)300–87
     Uninsured11.9 (22.0)50–100
    • FTE=full-time equivalent.

    • View popup
    Table 2

    Variable Cost of Practice Facilitation and Selected Facilitation Activities

    ActivityMedian Cost, $
    Key facilitation activity
    Total variable cost of all practice facilitation activities7,626
    Total travel and food cost of practice facilitation activities2,054
    Total variable cost9,670
    Selected facilitation activity
    Part A: variable cost of selected start-up activities
     Facilitation orientation cost375
     Direct time cost of completing baseline evaluation report3,075
     All other variable cost of start-up activities1,067
     Total cost of all start-up activities4,517
    Part B: variable cost for practice facilitation activities
     Cost for providing baseline feedback report474
     Cost of all facilitation materials provided660
     Cost of all actual practice facilitation activities during study1,315
     Total cost of practice facilitation2,449
    Part C: variable cost of monitoring following the practice facilitation
     Total cost of all monitoring activities448
    Part D: travel and food cost associated by practice facilitation activitiesa
     Total for start-up activities1,040
     Total for practice facilitation activities919
     Total for monitoring activities95
     Total travel and food cost2,054
    • ↵a Travel times reflect distance between clinic and facilitator’s office, the number of trips, and number of facilitators attending the meeting.

    • View popup
    Table 3

    Simulated Variable Cost of Practice Facilitation

    Simulation casesMedian Cost, $
    Simulation 1: Impact of change in hourly wage of practice facilitator on total facilitation cost
     Estimated total facilitation cost at $40 per hour wage11,797
     Estimated total facilitation cost at $50 per hour wage13,875
    Simulation 2: Impact of change in number of facilitation visits on total facilitation cost
     Estimated total facilitation cost with 12 practice facilitation visits11,085
     Estimated total facilitation cost with 24 practice facilitation visits15,098
    • Note: All simulation cost estimates include the variable cost of food or travel.

Additional Files

  • Tables
  • The Article in Brief

    Cost Estimates for Operating a Primary Care Practice Facilitation Program

    Steven D. Culler , and colleagues

    Background Practice facilitation is a promising and practical method for supporting practice redesign, but little is known about its cost. This article reports on costs of providing practice facilitation to small primary care practices.

    What This Study Found Practice facilitation using outside consultants is estimated to cost a small primary care practice between $9,670 and $15,098 per year, or the cost of two to three hospitalizations. The median direct cost of practice facilitation focused on improving chronic illness care, including 6 meetings over a 12-month period, is $9,670 per practice (range = $8,050 to $15,682). These estimates do not include overhead costs to the practice for staff and systems.

    Implications

    • Because much of the cost of practice facilitation is devoted to start-up and practice assessment, the costs of ongoing facilitation activities in subsequent years would likely be much lower than estimated above.
  • Supplemental Table

    Supplemental Table 1. Detailed Breakout of Total Variable Cost of Providing Selected Practice Facilitation Activities to Primary Care Clinics (Median Cost and Range of Costs)

    Files in this Data Supplement:

    • Supplemental data: Table - PDF file, 1 page, 165 KB
PreviousNext
Back to top

In this issue

The Annals of Family Medicine: 11 (3)
The Annals of Family Medicine: 11 (3)
Vol. 11, Issue 3
May/June 2013
  • Table of Contents
  • Index by author
  • In Brief
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Annals of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Cost Estimates for Operating a Primary Care Practice Facilitation Program
(Your Name) has sent you a message from Annals of Family Medicine
(Your Name) thought you would like to see the Annals of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
3 + 0 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Cost Estimates for Operating a Primary Care Practice Facilitation Program
Steven D. Culler, Michael L. Parchman, Raquel Lozano-Romero, Polly H. Noel, Holly J. Lanham, Luci K. Leykum, John E. Zeber
The Annals of Family Medicine May 2013, 11 (3) 207-211; DOI: 10.1370/afm.1496

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Get Permissions
Share
Cost Estimates for Operating a Primary Care Practice Facilitation Program
Steven D. Culler, Michael L. Parchman, Raquel Lozano-Romero, Polly H. Noel, Holly J. Lanham, Luci K. Leykum, John E. Zeber
The Annals of Family Medicine May 2013, 11 (3) 207-211; DOI: 10.1370/afm.1496
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • INTRODUCTION
    • METHODS
    • RESULTS
    • DISCUSSION
    • Footnotes
    • References
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • Dedicated Workforce Required to Support Large-Scale Practice Improvement
  • Qualitative evaluation of a cardiovascular quality improvement programmereveals sizable data inaccuracies in small primary care practices
  • Implementation of Health Insurance Support Tools in Community Health Centers
  • Engaging Primary Care Practices in Studies of Improvement: Did You Budget Enough for Practice Recruitment?
  • Practice Facilitators and Leaders Perspectives on a Facilitated Quality Improvement Program
  • Implementing Asthma Guidelines Using Practice Facilitation and Local Learning Collaboratives: A Randomized Controlled Trial
  • The Future of Family Medicine Version 2.0: Reflections from Pisacano Scholars
  • In This Issue: Practice Change--Context Matters
  • Practice Transformation? Opportunities and Costs for Primary Care Practices
  • Google Scholar

More in this TOC Section

  • Shared Decision Making Among Racially and/or Ethnically Diverse Populations in Primary Care: A Scoping Review of Barriers and Facilitators
  • Convenience or Continuity: When Are Patients Willing to Wait to See Their Own Doctor?
  • Feasibility and Acceptability of the “About Me” Care Card as a Tool for Engaging Older Adults in Conversations About Cognitive Impairment
Show more Original Research

Similar Articles

Subjects

  • Domains of illness & health:
    • Chronic illness
  • Methods:
    • Quantitative methods
  • Other research types:
    • Health policy
  • Other topics:
    • Quality improvement
    • Organizational / practice change

Keywords

  • health economics
  • practice facilitation
  • primary care practice transformation

Content

  • Current Issue
  • Past Issues
  • Early Access
  • Plain-Language Summaries
  • Multimedia
  • Podcast
  • Articles by Type
  • Articles by Subject
  • Supplements
  • Calls for Papers

Info for

  • Authors
  • Reviewers
  • Job Seekers
  • Media

Engage

  • E-mail Alerts
  • e-Letters (Comments)
  • RSS
  • Journal Club
  • Submit a Manuscript
  • Subscribe
  • Family Medicine Careers

About

  • About Us
  • Editorial Board & Staff
  • Sponsoring Organizations
  • Copyrights & Permissions
  • Contact Us
  • eLetter/Comments Policy

© 2025 Annals of Family Medicine