Measuring the Value-Functions of Primary Care: Provider Level Continuity of Care Measure

Identifying Attributes

Care Settings
Primary Care
Country
United States of America
Publishing Organisation
Payment program
Type of Quality Indicator
Process
IOM Quality Dimension
Efficiency
Domain
Service Delivery and Care Planning

Defining Attributes

Definition

This is a process measure evaluating primary care physicians; for each physician, their denominator is all of the patients they saw during the evaluation period who had at least 2 PCP visits (could include visits to other PCPs), and the numerator is the number of those patients whose Bice-Boxerman Continuity of Care Index is >= 0.7. The Bice-Boxerman index is a validated measure of patient-level care continuity that ranges from 0 to 1; 0 reflects completely disjointed care (a different provider for each visit) and 1 reflects complete continuity with the same provider for all visits.

Numerator

The number of patients with a continuity index of at least 0.7.

Denominator

The total number of patients with continuous enrolment with at least 2 visits to any primary care physicians in the measurement period. The requirement of continuous enrolment ensures that all of the patient encounters will be captured in the data, and the requirement of at least 2 visits is necessary to calculate a Continuity of Care index (the notion of "continuity" isn't applicable to someone who only has 1 physician visit, i.e., there needs to be at least 2 visits to determine if they consistently visit the same or different physicians).

Exclusions

Since Continuity of Care is about seeing the same clinician, we did not consider patients with only one visit as an exclusion, therefore; we do not have any denominator exclusions.

Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

None

Collection and Reporting Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Claims data

Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
No

Source and Reference Attributes

Evidence Source
Technical Specifications
Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
No
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
02 December 2025