Mimi Choate


December 2008

Document Type


Degree Name



Dept. of Public Health and Preventive Medicine


Oregon Health & Science University


In 2007 CareOregon implemented a medical home demonstration project called Primary Care Renewal (PCR) in several Portland-area safety-net clinics. The PCR intervention consists of six components: patient-centered care, team care delivery, proactive panel management, open access scheduling, integrated behavioral health, and intentional evaluation and change using PDSA cycles. This mixed-methods study used quantitative methods to evaluate the effect of PCR on provider productivity and qualitative methods to evaluate barriers and successes in implementation of PCR in two family medicine clinics. Pre- and post-intervention panel data was used to create multivariable models analyzing the effect of PCR on total monthly patients seen and total monthly relative value units accumulated by each provider (n=8). This quantitative analysis found that PCR was associated with a non-significant increase in the productivity of the two pilot providers (visits/month p-value=0.458, RVUs/month p-value=0.075). PCR was associated with a downward trend in productivity for six later starting providers (visits/month p-value=0.901, RVUs/month p-value=0.307). Each care team participated in a group interview to discuss barriers and successes in implementing the six components of PCR. This qualitative analysis found distinct differences among the care teams, specifically differences in team knowledge, support, leadership, and teamwork. These findings indicate that a team with these qualities can succeed both in implementing all the PCR components and increasing productivity.




School of Medicine



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.