Evaluating the Impact of Investment in Capital Infrastructure on Access to Primary Care

Profile

CHF’s Capital Infrastructure in Support of Team-based Comprehensive Primary Care funding opportunity focuses on expanding geographic access to primary care, behavioral health and dental services while promoting team-based care or improved health information technology systems. From its 2008 inception through 2021, the Foundation has provided 87 grants to 57 unique health care organizations serving a variety of regions in the state.

Summary

CHF and CIVHC partnered to understand the impact of primary care capital investment on communities in which those investments were made, and whether community members sought more primary care services due to the proximity of these clinics. Specifically, this analysis sought to understand whether capital infrastructure investments impact primary care utilization and access to behavioral health services. The analysis was conducted using Colorado All Payer Claims Database (CO APCD) claims from a subset of the 57 unique health care organizations to which CHF made capital investment grants, focusing on 10 clinics that were comprised of Federally Qualified Health Centers (FQHCs) and non-FQHCs.

Findings

Results from the analysis demonstrated that holding all else constant, patients of CHF primary care infrastructure grantees have higher per-member-per-year (PMPY) primary care utilization rates than individuals living within the service area who are not patients of the grantee facility (0.459 ± 0.021 visits more PMPY than non-patients). The trend comparison also appears to demonstrate that the 6-month visit rate is more stable for patients of grantees when compared to non-patient members in the service area.

Benefit to Colorado

Through strategic funding, CHF aims to improve health equity by increasing access to primary care for communities that have historically experienced inequitable health outcomes. CHF’s Capital Infrastructure in Support of Team-based Comprehensive Primary Care funding opportunity is intended to expand geographic access to care and develop facilities that promote better team-based care or improved health information technology systems. This evaluation demonstrates that the funding is effectively increasing access to primary care services for grantees and supports CHF’s goal to continue to enhance the capacity of clinics to serve more Coloradans with high-quality, comprehensive, and integrated primary care centered on patients’ preferences, needs, and values.