DHHS Releases Study Comparing NH Medicaid Members Receiving Primary Care Services

Concord, NH – The New Hampshire Department of Health and Human Services (DHHS) Office of Medicaid Business and Policy (OMBP) announces the release of a study comparing the experience New Hampshire Medicaid members received in different primary care settings. This study titled Comparison of Primary Care Received by NH Medicaid Members at Different Practice Settings is the first of its kind to examine the performance of practices throughout the state on key access, quality, utilization and cost measures.


“This report provides data and analysis that will be key to our success in managing health care costs of complex client cases balancing service costs, quality, access and outcomes,” said DHHS Commissioner Nicholas Toumpas. “It will also inform policy decisions focused on the realignment and integration of service delivery systems to one that is client centric.”


The study grouped New Hampshire Medicaid providers into five practice settings: hospital-based clinics and outpatient departments; federally qualified health centers (FQHCs); rural health clinics (RHCs); Dartmouth Hitchcock Clinics (DHC); and other office-based physician practices. DHHS set out to answer a number of questions including: Where do they receive primary care? Do members differ in where they receive care based on eligibity group, age, gender and health status? Does care for certain child and adult conditions vary by primary care practice setting? Does member service utilization vary by practice setting? Do member per month payments vary by practice setting?


The study found the majority of NH Medicaid members (34%) received primary care from physician office-based practices; hospital-based clinics and DHC each provided care to 15% of members; FQHCs (10%) and RHCs (5%) saw the remainder of NH Medicaid members (20% of members were not assigned either because they received no primary care or did not seek care from a primary care provider). Hospital-based clinics and office-based providers saw significantly sicker members. FQHCs and RHCs saw members with significantly lower risk.


There were a number of differences – significantly lower or higher rates – in effectiveness of care measures (e.g., well-child visits) across the primary care practice settings. Overall, NH Medicaid providers’ rates were higher than national Medicaid rates in most of the measures studied (despite the fact that the national rates are from managed care programs and NH Medicaid does not have a managed care program). However, there is still room for improvement.


“The NH Medicaid Program, like all public programs, must maximize the return on investment of every dollar spent on providing health care services to our 111,000 NH Medicaid beneficiaries,” said Medicaid Director Katie Dunn. “This data points us in the direction of where improvements need to be made in access and quality of care.”


Administrative eligibility and claims data from Calendar Year (CY) 2006 for more than 88,000 Medicaid members were used in this study to assign members to one of the primary care provider groups and to calculate the measures used in this study.


To read the complete study with all measures by primary care practice setting or for a copy of the Issue Brief visit DHHS’ website: www.dhhs.state.nh.us