{"id":"https://openalex.org/W2940360459","doi":"https://doi.org/10.1177/1062860619843350","title":"Aggregating Claims Data Across Payers: Approaches, Challenges, and Lessons Learned From the Comprehensive Primary Care Initiative","display_name":"Aggregating Claims Data Across Payers: Approaches, Challenges, and Lessons Learned From the Comprehensive Primary Care Initiative","publication_year":2019,"publication_date":"2019-04-16","ids":{"openalex":"https://openalex.org/W2940360459","doi":"https://doi.org/10.1177/1062860619843350","mag":"2940360459","pmid":"https://pubmed.ncbi.nlm.nih.gov/30991814"},"language":"en","primary_location":{"id":"doi:10.1177/1062860619843350","doi":"https://doi.org/10.1177/1062860619843350","is_oa":false,"landing_page_url":"https://doi.org/10.1177/1062860619843350","pdf_url":null,"source":{"id":"https://openalex.org/S133181607","display_name":"American Journal of Medical Quality","issn_l":"1062-8606","issn":["1062-8606","1555-824X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","fnege-4","jufo-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Medical Quality","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5029609598","display_name":"Anne Mutti","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I66531908","display_name":"Mathematica Policy Research","ror":"https://ror.org/02403vr89","country_code":"US","type":"facility","lineage":["https://openalex.org/I66531908"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Anne Mutti","raw_affiliation_strings":["Mathematica Policy Research, Washington, DC"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Mathematica Policy Research, Washington, DC","institution_ids":["https://openalex.org/I66531908"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5057680060","display_name":"Erin Fries Taylor","orcid":"https://orcid.org/0000-0003-1129-6655","observed_orcids":["https://orcid.org/0000-0003-1129-6655"]},"institutions":[{"id":"https://openalex.org/I66531908","display_name":"Mathematica Policy Research","ror":"https://ror.org/02403vr89","country_code":"US","type":"facility","lineage":["https://openalex.org/I66531908"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Erin Fries Taylor","raw_affiliation_strings":["Mathematica Policy Research, Washington, DC"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Mathematica Policy Research, Washington, DC","institution_ids":["https://openalex.org/I66531908"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5086774357","display_name":"Deborah N. Peikes","orcid":"https://orcid.org/0000-0002-1325-4283","observed_orcids":["https://orcid.org/0000-0002-1325-4283"]},"institutions":[{"id":"https://openalex.org/I66531908","display_name":"Mathematica Policy Research","ror":"https://ror.org/02403vr89","country_code":"US","type":"facility","lineage":["https://openalex.org/I66531908"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Deborah Peikes","raw_affiliation_strings":["Mathematica Policy Research, Washington, DC"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Mathematica Policy Research, Washington, DC","institution_ids":["https://openalex.org/I66531908"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110345939","display_name":"Janel Jin","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I50959184","display_name":"Centers for Medicare and Medicaid Services","ror":"https://ror.org/02g02rq35","country_code":"US","type":"government","lineage":["https://openalex.org/I1299022934","https://openalex.org/I50959184"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Janel Jin","raw_affiliation_strings":["Centers for Medicare & Medicaid Services, Baltimore, MD"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Centers for Medicare & Medicaid Services, Baltimore, MD","institution_ids":["https://openalex.org/I50959184"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5045599301","display_name":"Kristie Liao","orcid":"https://orcid.org/0009-0003-4392-0245","observed_orcids":["https://orcid.org/0009-0003-4392-0245"]},"institutions":[{"id":"https://openalex.org/I66531908","display_name":"Mathematica Policy Research","ror":"https://ror.org/02403vr89","country_code":"US","type":"facility","lineage":["https://openalex.org/I66531908"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Kristie Liao","raw_affiliation_strings":["Mathematica Policy Research, Washington, DC"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Mathematica Policy Research, Washington, DC","institution_ids":["https://openalex.org/I66531908"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5103845848","display_name":"Ha Tu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I66531908","display_name":"Mathematica Policy Research","ror":"https://ror.org/02403vr89","country_code":"US","type":"facility","lineage":["https://openalex.org/I66531908"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Ha Tu","raw_affiliation_strings":["Mathematica Policy Research, Washington, DC"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Mathematica Policy Research, Washington, DC","institution_ids":["https://openalex.org/I66531908"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5029609598"],"corresponding_institution_ids":["https://openalex.org/I66531908"],"apc_list":null,"apc_paid":null,"fwci":0.2658,"has_fulltext":false,"cited_by_count":2,"citation_normalized_percentile":{"value":0.54526046,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":93},"biblio":{"volume":"35","issue":"1","first_page":"29","last_page":"36"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11590","display_name":"Primary Care and Health Outcomes","score":0.948199987411499,"subfield":{"id":"https://openalex.org/subfields/2714","display_name":"Family Practice"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11590","display_name":"Primary Care and Health Outcomes","score":0.948199987411499,"subfield":{"id":"https://openalex.org/subfields/2714","display_name":"Family Practice"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.04170000180602074,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11722","display_name":"Patient Satisfaction in Healthcare","score":0.002899999963119626,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/payers","display_name":"payers","score":0.5699999928474426},{"id":"https://openalex.org/keywords/primary-care-practices","display_name":"primary care practices","score":0.9010000228881836},{"id":"https://openalex.org/keywords/performance-feedback","display_name":"performance feedback","score":0.8330000042915344},{"id":"https://openalex.org/keywords/data-sharing","display_name":"data sharing","score":0.46399998664855957},{"id":"https://openalex.org/keywords/data-privacy","display_name":"data privacy","score":0.382999986410141},{"id":"https://openalex.org/keywords/quality-of-care-measurement","display_name":"quality of care measurement","score":0.38100001215934753},{"id":"https://openalex.org/keywords/organizational-alliances","display_name":"organizational alliances","score":0.34200000762939453}],"concepts":[{"id":"https://openalex.org/C141141315","wikidata":"https://www.wikidata.org/wiki/Q2379942","display_name":"Guard (computer science)","level":2,"score":0.6762675642967224},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6684295535087585},{"id":"https://openalex.org/C2984752397","wikidata":"https://www.wikidata.org/wiki/Q3259956","display_name":"Primary care","level":2,"score":0.6144407391548157},{"id":"https://openalex.org/C71745522","wikidata":"https://www.wikidata.org/wiki/Q2476929","display_name":"Confidentiality","level":2,"score":0.5923716425895691},{"id":"https://openalex.org/C184356942","wikidata":"https://www.wikidata.org/wiki/Q830382","display_name":"Best practice","level":2,"score":0.5484814643859863},{"id":"https://openalex.org/C76178495","wikidata":"https://www.wikidata.org/wiki/Q4808784","display_name":"Asset (computer security)","level":2,"score":0.42041462659835815},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.37380483746528625},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.16544818878173828},{"id":"https://openalex.org/C38652104","wikidata":"https://www.wikidata.org/wiki/Q3510521","display_name":"Computer security","level":1,"score":0.11831149458885193},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.08541998267173767},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.08101195096969604},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.0},{"id":"https://openalex.org/C199360897","wikidata":"https://www.wikidata.org/wiki/Q9143","display_name":"Programming language","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D003191","descriptor_name":"Comprehensive Health Care","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D003191","descriptor_name":"Comprehensive Health Care","qualifier_ui":"Q000458","qualifier_name":"organization & administration","is_major_topic":false},{"descriptor_ui":"D006278","descriptor_name":"Medicare","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011320","descriptor_name":"Primary Health Care","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":false},{"descriptor_ui":"D011787","descriptor_name":"Quality of Health Care","qualifier_ui":"Q000458","qualifier_name":"organization & administration","is_major_topic":true},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018588","descriptor_name":"Fee-for-Service Plans","qualifier_ui":"Q000458","qualifier_name":"organization & administration","is_major_topic":true},{"descriptor_ui":"D018802","descriptor_name":"Patient-Centered Care","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1177/1062860619843350","doi":"https://doi.org/10.1177/1062860619843350","is_oa":false,"landing_page_url":"https://doi.org/10.1177/1062860619843350","pdf_url":null,"source":{"id":"https://openalex.org/S133181607","display_name":"American Journal of Medical Quality","issn_l":"1062-8606","issn":["1062-8606","1555-824X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","fnege-4","jufo-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Medical Quality","raw_type":"journal-article"},{"id":"pmid:30991814","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/30991814","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American journal of medical quality : the official journal of the American College of Medical Quality","raw_type":"Journal Article"},{"id":"pmh:oai:RePEc:mpr:mprres:f646e461b99c41559bada0006fe6a5a2","doi":null,"is_oa":false,"landing_page_url":"https://journals.sagepub.com/doi/10.1177/1062860619843350","pdf_url":null,"source":{"id":"https://openalex.org/S4306401271","display_name":"RePEc: Research Papers in Economics","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I77793887","host_organization_name":"Federal Reserve Bank of St. Louis","host_organization_lineage":["https://openalex.org/I77793887"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"preprint"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.46810001134872437,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[{"id":"https://openalex.org/G4906985045","display_name":null,"funder_award_id":"contract HHSM-500-2010-00026I/HHSM-500-T0006.","funder_id":"https://openalex.org/F4320332205","funder_display_name":"Centers for Medicare and Medicaid Services"}],"funders":[{"id":"https://openalex.org/F4320332205","display_name":"Centers for Medicare and Medicaid Services","ror":"https://ror.org/02g02rq35"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":8,"referenced_works":["https://openalex.org/W796164505","https://openalex.org/W2020155291","https://openalex.org/W2106675704","https://openalex.org/W2165570106","https://openalex.org/W2529683963","https://openalex.org/W2591948034","https://openalex.org/W2748814265","https://openalex.org/W2754503912"],"related_works":["https://openalex.org/W2748814265","https://openalex.org/W2754503912","https://openalex.org/W6998523289","https://openalex.org/W2535520146","https://openalex.org/W2804877248","https://openalex.org/W3042013354","https://openalex.org/W2371295515","https://openalex.org/W2998129329","https://openalex.org/W2602588285","https://openalex.org/W2098904681"],"abstract_inverted_index":{"The":[0],"Comprehensive":[1],"Primary":[2],"Care":[3],"(CPC)":[4],"initiative":[5],"fueled":[6],"the":[7,32,71,109],"emergence":[8],"of":[9,31,40,55,142],"new":[10],"organizational":[11],"alliances":[12],"and":[13,18,50,114,119],"financial":[14],"commitments":[15],"among":[16],"payers":[17,66,94,134],"primary":[19,136],"care":[20,137],"practices":[21,34,138],"to":[22,73,83],"use":[23],"data":[24,75,92,110,132],"for":[25,88,135],"performance":[26,86,103],"improvement.":[27],"In":[28],"most":[29],"regions":[30,69],"country,":[33],"received":[35],"separate":[36],"confidential":[37],"feedback":[38,87],"reports":[39],"claims-based":[41],"measures":[42],"from":[43],"multiple":[44],"payers,":[45],"which":[46],"varied":[47],"in":[48,67,100],"content":[49],"provided":[51],"an":[52],"incomplete":[53],"picture":[54],"a":[56,77,96],"practice's":[57],"patient":[58],"panel.":[59],"Over":[60],"CPC's":[61],"last":[62],"few":[63],"years,":[64],"participating":[65],"several":[68],"resisted":[70],"tendency":[72],"guard":[74],"as":[76],"proprietary":[78],"asset,":[79],"instead":[80],"working":[81],"collaboratively":[82],"produce":[84],"aggregated":[85],"practices.":[89],"Aggregating":[90],"claims":[91,129],"across":[93,133],"is":[95],"potential":[97],"game":[98],"changer":[99],"improving":[101],"practice":[102],"because":[104],"doing":[105],"so":[106],"potentially":[107],"makes":[108],"more":[111],"accessible,":[112],"comprehensive,":[113],"useful.":[115],"Understanding":[116],"lessons":[117],"learned":[118],"key":[120],"challenges":[121],"can":[122],"help":[123],"other":[124,140],"initiatives":[125],"that":[126],"are":[127],"aggregating":[128],"or":[130,139],"clinical":[131],"types":[141],"providers.":[143]},"counts_by_year":[{"year":2025,"cited_by_count":1},{"year":2020,"cited_by_count":1}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2019-04-25T00:00:00"}