Estimated Implementation and Maintenance Costs of Performance Data Reporting in 8 Primary Care Practices, by Program and Practice
| Implementation Costs $ | Maintenance (Annualized) Costs $ | |||||||
|---|---|---|---|---|---|---|---|---|
| Program and Practice | Total | Per Clinician FTE | Incurred by Programa | Total | Per Clinician FTE | Incurred by Programa | Major Cost Sources, $ | Estimated Incentive Payment (per FTE), $ |
| AM = annualized maintenance cost; CEO = chief executive officer; EHR = electronic health record; IT = information technology; n/a = not available; QI = quality improvement; S=start-up cost. | ||||||||
| a Includes only the estimated cost of program services delivered on-site in the primary care practice. | ||||||||
| b No maintenance participation costs available either because of nature of program (no maintenance phase of reporting) or insufficient time in program. | ||||||||
| c CCNC started in 1998; several practices did not have access to costs data from implementation. | ||||||||
| d Participating practices received $2.50 per patient per month, primarily for case management; payment was not tied to data reporting. | ||||||||
| Physician Quality Reporting Initiative (PQRI) | ||||||||
| A | 5,949 | 425 | 0 | 12,200 | 871 | 0 | S/AM: Data entry by clinicians and billing staff | 7,000 (500) |
| B | 920 | 368 | 0 | 207 | 83 | 0 | None | 0; denied incentive due to operational issues |
| D | 22,200 | 11,100 | 0 | 8,657 | 4,329 | 0 | S: Personnel time to collaborate with others (laboratory, Medicare, a patient revenue management company); internal meetings to plan and comply with the program | 4,000 (1,000) |
| S/AM: Technical support with server, and server upgrades | ||||||||
| H | 5,894 | 475 | 0 | 7,200 | 581 | 0 | S: Data entry time; leadership meetings | 2,000 (210) |
| AM: Data entry by clinicians and IT personnel costs for program monitoring | ||||||||
| Improving Performance in Practice (IPIP) | ||||||||
| B | 3,571 | 1,428 | 2,545 | 5,044 | 2,018 | 141 | S/AM: Maintaining the active list of patients; data entry | 2,000 (800) |
| C | 2,689 | 2,689 | 1,000 | 4,229 | 4,229 | 820 | S/AM: Data abstraction by clinician | 2,000 (2,000) |
| F | 18,210 | 3,035 | 1,673 | 11,563 | 1,927 | 1,673 | S/AM: Meetings; staff time to develop work- around for laboratory values (because of lack of information interoperability) | 2,000 (333) |
| Bridges to Excellence: Diabetes (DPRP) | ||||||||
| A | 8,658 | 618 | 0 | 2,940 | $205 | $0 | S: Internal audit to verify data accuracy (not required by QI organization). | 7,500 year 1 (536) 12,000 year 2 (857) |
| S/AS: Administrative meetings | ||||||||
| G | 4,270 | 488 | 45 | n/ab | n/ab | n/ab | S: Planning and decision making | 0; could not submit |
| S: Data entry and backup work | ||||||||
| Bridges to Excellence: Physician Practice Connections (PPC) | ||||||||
| A | 11,294 | $807 | $0 | n/ab | n/ab | $0 | S: Meetings of decision makers and/or stakeholders | 65,000, year 1 (4,642) 35,000, year 2 (2,500) |
| Community Care of North Carolina (CCNC) | ||||||||
| A | 1,865 | 133 | 1,266 | 2,954 | 211 | 1,147 | S/AM: Regional meeting attendance | 0d |
| B | 709 | 284 | 268 | 146 | 58 | 197 | S: Initiation of new processes for some measures; meetings and work to credential clinicians | 0d |
| AS: Report review | ||||||||
| C | 563 | 563 | 261 | n/ab | n/ab | n/ab | S/AS: Regional meeting attendance; chart audits required staff participation due to EHR | 0d |
| D | n/ac | n/ac | n/ac | 719 | 360 | 1,628 | S/AS: Internal meetings; audit preparation; audits required office staff participation because of EHR | 0d |
| E | n/ac | n/ac | n/ac | 761 | 146 | 1,022 | AM: Network meetings, some report review by CEO | 0d |
| G | n/ac | n/ac | n/ac | 2,788 | 319 | 5,477 | S/AM: High Medicaid volume resulted in case manager on site, who provided direct teaching of personnel; audits required office staff participation because of EHR | 0d |