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Research Letter
July 2017

Patient Dismissal by Primary Care Practices

Author Affiliations
  • 1Mathematica Policy Research, Washington, DC
  • 2Mathematica Policy Research, Princeton, New Jersey
  • 3Centers for Medicare & Medicaid Services, Baltimore, Maryland
JAMA Intern Med. 2017;177(7):1048-1050. doi:10.1001/jamainternmed.2017.1309

Patient dismissal, the termination of a relationship with a patient by a health care professional, can affect access to care. Although understudied, the topic is important, especially as insurers begin to shift payment from volume to value. Patient dismissal could be an unintended consequence of this shift as clinicians face (or perceive that they face) pressure to limit their panel to patients for whom they can readily demonstrate value in order to maximize revenue.1 We examined the prevalence of and reasons for patient dismissal among primary care practices participating in the Comprehensive Primary Care (CPC) initiative and a matched sample of comparison practices. The CPC and responding comparison practices had similar market-, practice- and patient-level characteristics.2,3

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