Primary care practices are too small for Medicare to assess quality, study shows

Most primary care physicians work in practices with too few Medicare patients to measure differences of quality and cost performance, according to a study in the December 9 issue of the Journal of the American Medical Association.

Caseloads necessary to detect 10 percent relative differences in costs and quality were calculated using national average ambulatory Medicare spending, rates of mammography, hemoglobin A1c testing, preventable hospitalization rate, and readmission rate after discharge.

The Centers for Medicare & Medicaid researchers found that primary care physician practices had annual median caseloads of 260 Medicare patients, 25 women eligible for mammography, 30 patients with diabetes eligible for hemoglobin A1c testing, and 0 hospitalized patients.