Pediatric emergency department (ED) visits for mental health are costly and often preventable. Access to primary care behavioral providers can improve reduce unnecessary ED visits. Quantitative analysis of the Virginia All-Payers Claims Database assess outpatient children adolescents up age 21 years between 2016 2021. We determined proportion seen by or one week year before an visit, how many had follow-up within two months after. Results: From 2021, pediatric dropped 14%, but rose 10.6%,...

Background Patients with type 2 diabetes require recommendations for self-management education and support. Objective In this study, we aim to design the Diabetes Engagement Activation Platform (DEAP)—an automated patient tool integrated into primary care workflow—and examine its implementation effectiveness. Methods We invited patients aged 18-85 years a hemoglobin A1c (HbA1c) level ≥8 participate in randomized controlled trial comparing DEAP usual care. modules addressing support domains...

<h3>Background:</h3> Primary care is crucial to the health of individuals and communities, but it faces numerous structural systemic challenges. Our study assessed state primary in Virginia prepare for Medicaid expansion. It also provides insight into frontline prior an unprecedented global COVID-19 pandemic. <h3>Methods:</h3> We surveyed 1622 practices understand organizational characteristics, scope care, capacity, stress. <h3>Results:</h3> Practices (484) varied type, ownership, location,...

<h3>Context</h3> Primary care physicians often help patients with mental health concerns, but little is known about patients' views of addressing their needs within the primary setting. <h3>Objective</h3> We evaluated change in self-reported progress and confidence among identified as having one or more risks who wanted to improve these by creating a personal plan. <h3>Study Design Analysis</h3> Quantitative study. <h3>Setting Dataset</h3> The data source was My Own Health Report (MOHR)....

<h3>Background:</h3> Access to high-quality primary care requires adequate numbers of physicians (PCPs) as well appropriate clinician panel size. Excess number patients per has been associated with higher physician burnout and may hinder timely patient access care. Despite these important implications, there have few studies date investigating the dimensions optimal This study aims review variations in size based on practice population characteristics. <h3>Methods:</h3> We queried 2021...

<h3>Introduction:</h3> The opioid epidemic results in over 100,000 deaths annually. Virginia and many other states have received funding from national-level settlements, administered through the Opioid Abatement Authority (OAA), to help combat this crisis. We are developing an online toolkit city county officials identify implement evidence-based strategies address mortality. While resources already exist, initiative aims provide both broad individualized content cities counties them...

<h3>Context:</h3> There has been a steady increase in pediatric emergency department (ED) visits for mental health. These are costly and preventable, representing failure to address the health needs of children. Increasing access primary care clinicians who better able screen treat conditions can improve reduce unnecessary ED visits. The Virginia Mental Health Access Program (VMAP) is statewide initiative that helps providers take children adolescents with through provider education...

Objectives: Guidelines recommend addressing health behaviors, mental health, and social needs in primary care. However, it is unclear how often patients want support to address these risks. As part of a randomized trial comparing enhanced care planning versus usual care, we evaluated what risks wanted address. Methods: All with multiple chronic conditions, 1 or more which was uncontrolled, from 81 clinicians 30 practices. Using My Own Health Report (MOHR), identified prioritized their create...

<h3>Context:</h3> High quality primary care results in longer lives and more equity. Despite its high value, is under-resourced under perpetual stress. Clearly the COVID pandemic was a major stress, long-term impacts are still being felt by practices. <h3>Objective:</h3> We sought to assess current state of stress how it has impacted provision high-quality care. <h3>Study Design:</h3> Mixed methods evaluation practice surveys semi-structured interviews. <h3>Population studied:</h3> Every...

<h3>Context:</h3> The prevalence of multiple chronic conditions (MCC) – defined as having two or more medical - is increasing in the U.S. In spite a greater typical number primary care encounters, patients living with MCCs have been found less likely to receive up-to-date preventive healthcare services. screening rate for unhealthy alcohol use among not well-established. <h3>Objective:</h3> To assess MCC. <h3>Study Design and Analysis:</h3> We performed cross-sectional analysis chart review...

<h3>Background:</h3> Practice ownership has an impact on quality improvement, provision of low value care, and burnout. As hospital expands clinician owned practices become less common, it is necessary to quantify the differences in practice patient characteristics that are associated with ownership. <h3>Objective:</h3> This study aims identify characteristics, stressors, access for primary care by <h3>Study design, Setting:</h3> A cross-sectional survey was fielded all between...

<h3>Context:</h3> Patients with multiple chronic conditions (MCC) have unmet social needs, mental health challenges, and unhealthy behaviors. Both disease health-related needs influence a patient’s quality of life (QOL). One approach to addressing patient QOL is through care planning. However, little understood about the relations between QOL, planning preferences. <h3>Objective:</h3> To describe how patients’ relates their plans they choose create. <h3>Study Design Analysis:</h3> In...

<h3>Context:</h3> The US healthcare system suffers from high costs, suboptimal health outcomes, and a fragmented primary care system, at least in part due to fee-for-service payment model. National Academies of Sciences, Engineering, Medicine recommend transition alternative models (APMs) as pathway implementing high-quality care. Many suggest that practices need 25% APM-attributable revenue (AAR) order see change. <h3>Objective:</h3> We sought assess the adoption APMs among Virginia....

Context: Patients with MCC have a range of needs that extend beyond traditional medical care including behavioral, mental health, and social needs. While primary does its best to address these needs, few practices can undertake systematic approach without broader health system coordinated community support. We are conducting randomized controlled trial compare package four tools (an online risk assessment called My Own Health Report (MOHR), patient navigator, worker, linkage programs) versus...

<h3>Context:</h3> Patients with multiple chronic conditions (MCC) may have unmet behavioral, mental, and social needs which can be difficult to address in primary care. Care planning provides a framework for patients screened, collaborate on care plan, access patient navigator who support them achieving their personal health goals. <h3>Objective:</h3> To compare patients’ progress confidence addressing plans different topics. <h3>Study Design Analysis:</h3> Clinician level randomized control...

<h3>Context:</h3> Social determinants of health, which play an essential role in overall patient outcomes, are routinely addressed primary care settings. Primary providers coordinate care, offer behavioral and mental health services, connect patients with community resources. The COVID-19 pandemic may have changed the availability delivery social support services <h3>Objective:</h3> To assess how food security, transportation support, housing Virginia settings between 2018-2021. <h3>Study...

<h3>Context:</h3> Unhealthy alcohol use (UAU) is the third leading cause of preventable death. While several screening tools with reliable sensitivity and specificity are recommended for screening, they not routinely used. As a result, UAU often missed interventions such as brief counseling, motivational interviewing, medication treatment, referrals infrequently provided. <h3>Objective:</h3> This four-year AHRQ-funded study aimed to enroll practices evaluate effect practice facilitation...

<h3>Background:</h3> There is a critical shortage of primary care physicians (PCPs). Current estimates on the scope are based theoretical assumptions about what clinician's panel size should be, with 1800 to 2500 being commonly cited for full-time clinician. However, as tasks required delivering high-quality extend beyond mere office visits, these estimations may not be accurate. Understanding how many patients PCPs actually see give better happening in real world. Virginia serves valuable...

<sec> <title>BACKGROUND</title> Patients with type 2 diabetes require recommendations for self-management education and support. </sec> <title>OBJECTIVE</title> In this study, we aim to design the Diabetes Engagement Activation Platform (DEAP)—an automated patient tool integrated into primary care workflow—and examine its implementation effectiveness. <title>METHODS</title> We invited patients aged 18-85 years a hemoglobin A&lt;sub&gt;1c&lt;/sub&gt; (HbA&lt;sub&gt;1c&lt;/sub&gt;) level ≥8...

Objectives: To help better control chronic conditions we need to address root causes of poor health like unhealthy behaviors, mental health, and social needs. However, addressing these needs in primary care is difficult. One solution may be connecting patients with a navigator for support creating personal goal. Methods: As part an RCT evaluate feasible approach planning, 24 clinicians from 12 practices the Virginia Ambulatory Care Outcomes Research Network (ACORN) 87 intervention...