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The American Journal of Accountable Care June 2018
Amazing Grace: A Free Clinic's Transformation to the Patient-Centered Medical Home Model
Jason Alexander, BS, PCMH CCE; Jordon Schagrin, MHCI, PCMH CCE; Scott Langdon, BA; Meghan Hufstader Gabriel, PhD; Kendall Cortelyou-Ward, PhD; Kourtney Nieves, PhD; Lauren Thawley, MSHSA; and Vincent Pereira, MHA, PCMH CCE
Lessons Learned in Implementing Behavioral Screening and Intervention
Richard L. Brown, MD, MPH
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Taylor Justice, MBA, President of Unite Us
Case Study: Encouraging Patients to Schedule Annual Physicals
Nicholas Ma
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William R. Doucette, PhD; Yiran Zhang, PhD, BSPharm; Jane F. Pendergast, PhD; and John Witt, BS
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Are Medical Offices Ready for Value-Based Reimbursement? Staff Perceptions of a Workplace Climate for Value and Efficiency
Rodney K. McCurdy, PhD, and William E. Encinosa, PhD
Cost-Effectiveness of Pharmacist Postdischarge Follow-Up to Prevent Medication-Related Admissions
Brennan Spiegel, MD, MSHS; Rita Shane, PharmD; Katherine Palmer, PharmD; and Duong Donna Luong, PharmD

Are Medical Offices Ready for Value-Based Reimbursement? Staff Perceptions of a Workplace Climate for Value and Efficiency

Rodney K. McCurdy, PhD, and William E. Encinosa, PhD
This study surveyed 840 clinical and nonclinical staff in 96 medical offices regarding workplace policies and procedures that facilitate a climate for value. 

Objectives: As value-based reimbursement prepares to enter the outpatient setting, little is known about medical offices’ preparedness to face this challenge. Although workplace climate is a strong predictor of organizational performance and patient outcomes, there is a critical lack of evidence regarding a climate for value in frontline medical offices. Our goal was to assess medical office staff member perceptions of a workplace climate for value.

Study Design: The Medical Office Value and Efficiency Survey, developed by the Agency for Healthcare Research and Quality, was pilot-tested among 2315 workers in 96 medical offices. Of these, 840 completed surveys, 57% of whom were clinical staff members. Most respondents worked full time (86%), had been at their current place of employment for at least 1 year (83%), and worked in larger practices with 11 or more clinical staff (70%).

Methods: Percentage of positive survey responses was used for comparisons by occupational role and organizational context.

Results: Medical office staff positively responded to 44.6% of the 25 climate survey statements. Clinical staff were more positive, but few had used data to assess the results of performance improvement activities (8.8%), shadowed patients to improve their care experience (12.4%), or served on a committee to make a work process more efficient (15.7%). Among nonclinical staff, those working in smaller medical offices had more positive perceptions than those in larger offices.

Conclusions: Findings highlight the need for management strategies that emphasize staff training and engagement and the use of performance data and that stress value principles across all organizational activities, including workforce development, performance management, and recruitment.

The American Journal of Accountable Care. 2018;6(2):11-19

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