MetroHealth Care Plus: Effects Of A Prepared Safety Net On Quality Of Care In A Medicaid Expansion Population.

Studies of Medicaid expansion have produced conflicting results about whether the expansion is having a positive impact on health and the cost and efficiency of care delivery. To explore the issue further, we examined MetroHealth Care Plus, a Centers for Medicare and Medicaid Services (CMS) waiver program in Ohio composed of three safety-net organizations that enrolled 28,295 uninsured poor patients in closed-panel care during 2013. All participating organizations used electronic health records and patient-centered medical homes, publicly reported performance in a regional health improvement collaborative, and accepted a budget-neutral cap approved by CMS.

Performance metrics for advanced access.

Advanced access is an outpatient scheduling technique that aims to provide sameday appointment access. It is designed to reduce the time patients must wait for a scheduled appointment and to improve continuity of care by matching daily appointment supply and demand. Factors that make it difficult to sustain initial success in achieving supply-demand balance include different practice styles of doctors, differences in panel compositions and patient preferences, and time-varying demand patterns.