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

Identifying Attributes

Care Settings
Primary Care
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Traditional Merit-Based Incentive Payment System (MIPS) Qualified Clinical Data Registry Measures for Primary Care
Type of Quality Indicator
Process
IOM Quality Dimension
Effectiveness
Domain
Service Delivery and Care Planning

Defining Attributes

Definition

This is a measure evaluating primary care physicians (PCPs); for each PCP, the denominator is all patients seen during the evaluation period who had at least 2 PCP visits.

Numerator

The numerator is the number of patients with a continuity index of at least 0.7. Numerator Details: For each patient, the continuity index score is calculated using the Bice-Boxerman Continuity of Care calculated as follows: Bice Boxerman-Continuity of Care Patient =(Summation(i=1)^k ni^2)-N/(N(N-1)) where k is the number of PCPs, n_i is the number of visits to PCP i and N is the total number of visits. (Note that it is necessary that the patient has at least two visits.) The index can range from 0 to 1, the higher the number the greater the Continuity of Care. If someone has all their visits with a single PCP, their index will equal 1.

Denominator

The denominator is the total number of patients with at least 2 visits to any PCPs during the measurement period. The denominator is calculated by summing the total number of patients with two or more primary care visits who had at least one of those visits with that physician. A patient with visits to more than one physician will appear in the denominator for the physician who saw the patient the most. DENOMINATOR NOTE: The requirement of at least 2 visits is necessary to calculate a Continuity of Care index. Denominator Criteria (Eligible Cases): The denominator is the total number of patients with continuous enrolment with at least 2 visits to any primary care physicians in the measurement period.

Exclusions
Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

Data Attributes

Type of Data Collection
Standardised clinical data
Data Collection Methods

ABFM PRIME - EHR; Registry; Other: EHR: Administrative data, Registry: PRIME, Other: Patient administrative data, physician EHR, PRIME Registry

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

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
23 July 2025