The Impact of Patient Complexity on Healthcare Utilization

Inclusion criteria for clinics: Clinics must be a clinic that offers Primary Care (Family Medicine Clinics, Pediatrics Clinics, General Practice Clinics, Internal Medicine clinics that are not limited to a subspecialty focus, and multi-specialty clinics that include primary care providers as part of a comprehensive care team.) Clinics must have implemented their EHR by 1/1/2014. Inclusion criteria for patients: EHR Patients must be established patients within a health care system: at least one ambulatory visit to an included clinic in 2015 and at least 1 visit to a primary care clinic within the same health system prior to that visit. Inclusion criteria for patients for Medicaid based Outcomes: Patient must have been continuously covered by Medicaid in 2015 and have had at least 1 visit billed as an office visit in 2015 with a provider identified as a primary care provider and at least 1 prior claim billed to the same provider. Patients must meet the age/condition criteria for the assessment of at least 1 secondary outcome. Exclusion Criteria: Exclusion criteria for patients: Patients with no geocoded address on file will be excluded from the analysis. Exclusion criteria for patients for Medicaid based Outcomes: Patient with Medicaid coverage gaps of \>45 days will be excluded from theses analyses. Exclusion criteria for providers: Providers with \<20 patients in any Quality metric denominator.