Patient empanelment: A strategy to improve continuity and quality of patient care

Problem: In some Federally-Qualified Community Health Centers (FQHCs), patients do not have a designated primary care provider (PCP). Patients see any provider who is available. This leads to fragmented care, poorer outcomes, and higher costs.

Design: Patients were empaneled to a designated PCP. Continuity, quality, and efficiency measures were collected at baseline, 6-, and 12-months postempanelment.

Background and setting: Three rural FQHCs on the coast of Northern California performing about 18,000 patient visits annually.

Key measures for improvement: Patient cycle time, percentage of patient visits with designated PCPs, completion of cervical and colorectal cancer screenings; blood pressure, low-density lipoprotein, and hemoglobin A1c control in patients with diabetes.

Strategies for change: The senior Leadership Team initiated the patient empanelment project with the assistance of an outside consultant.

Effects of change: After 12 months, 100% of the FQHC's patients were assigned a PCP and saw that provider on ≥63% of visits. Quality indicators improved by an average of 9% and cycle time decreased by 12 min. per patient allowing providers to see approximately four more patients and generate an additional $2212 per day.

Lessons learnt: Project outcomes supported the importance of a designated PCP to achieve improved quality and efficiency of care.