• Matthew E Bernard, Michael P Halasy, David R Rushlow, Gerald J Sobolik, Gregory M Garrison, Marc R Matthews, Summer V Allen, and Thomas D Thacher.
• Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA.
• J Eval Clin Pract. 2022 Dec 1; 28 (6): 105510601055-1060.

ObjectiveTo evaluate health care costs as a function of assigned primary care clinician type and care team characteristics.MethodsAdministrative data were collected for 68 family medicine clinicians (40 physicians and 28 nurse practitioners [NPs]/physician assistant [PAs]), on 11 care teams (variable MD, NP and PA on teams), caring for 77,141 patients. We performed a generalized linear mixed multivariable regression model of standardized per member per month (PMPM) median cost as the outcome, with four practice sites included as random effects.ResultsIn bivariate analysis, cost was higher in physicians than NP/PAs, in more complex patients, and associated with emergency department (ED) visit rate. On multivariate analysis, patient complexity, ED visit rate and higher patient experience ratings were independently associated with greater PMPM cost. More time in practice was associated with lower PMPM cost. In the adjusted multivariate model, physicians had 8.3% lower median PMPM costs than NP/PAs (p = 0.046).ConclusionsThe primary drivers of greater PMPM cost were patient complexity, ED visits and patient satisfaction.© 2022 John Wiley & Sons Ltd.

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