Article Figures & Data
Tables
- Table 1
Selected Baseline Characteristics of Clinical Practices Receiving Practice Facilitation Activities (N = 19 practices)
Characteristic Mean (SD) Median Range FTE personnel, No. Physicians, medical and osteopathic 1.05 (0.22) 1.0 1–2 Physicians assistants 0.31 (0.58) 0.0 0–1 Nurse practitioners 0.11 (0.31) 0 0–1 Office staff 6.1 (2.4) 5 2–12 Health information technology, % Electronic patient scheduling 94.7 – – Electronic clinical patient management 63.2 – – Electronic prescribing 31.6 – – Electronic referral request submission 31.6 – – Patient volume per clinician Office visits per day per FTE clinician, No. 24.0 (4.9) 25 18–35 Hospital visits per week, No. 4.08 (7.39) 0 0–25 Practice routinely measures patient satisfaction, % 21.2 – – Patient insurance status, No. Medicare 30.5 (22.9) 25 0–80 Medicaid 14.5 (20.1) 5 0–80 Capitation 9.6 (17.0) 0 0–48 Fee for service 33.4 (31.1) 30 0–87 Uninsured 11.9 (22.0) 5 0–100 -
FTE=full-time equivalent.
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Activity Median Cost, $ Key facilitation activity Total variable cost of all practice facilitation activities 7,626 Total travel and food cost of practice facilitation activities 2,054 Total variable cost 9,670 Selected facilitation activity Part A: variable cost of selected start-up activities Facilitation orientation cost 375 Direct time cost of completing baseline evaluation report 3,075 All other variable cost of start-up activities 1,067 Total cost of all start-up activities 4,517 Part B: variable cost for practice facilitation activities Cost for providing baseline feedback report 474 Cost of all facilitation materials provided 660 Cost of all actual practice facilitation activities during study 1,315 Total cost of practice facilitation 2,449 Part C: variable cost of monitoring following the practice facilitation Total cost of all monitoring activities 448 Part D: travel and food cost associated by practice facilitation activitiesa Total for start-up activities 1,040 Total for practice facilitation activities 919 Total for monitoring activities 95 Total travel and food cost 2,054 -
↵a Travel times reflect distance between clinic and facilitator’s office, the number of trips, and number of facilitators attending the meeting.
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Simulation cases Median Cost, $ Simulation 1: Impact of change in hourly wage of practice facilitator on total facilitation cost Estimated total facilitation cost at $40 per hour wage 11,797 Estimated total facilitation cost at $50 per hour wage 13,875 Simulation 2: Impact of change in number of facilitation visits on total facilitation cost Estimated total facilitation cost with 12 practice facilitation visits 11,085 Estimated total facilitation cost with 24 practice facilitation visits 15,098 -
Note: All simulation cost estimates include the variable cost of food or travel.
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Additional Files
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
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