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Work group debates access measures: continuity index, CHIS survey and HPD claims
Summary
Participants discussed three candidate access indicators—Bice‑Boxerman continuity index, primary care visits per 1,000 and adults with a routine checkup (CHIS)—balancing claims‑based completeness against CHIS race/ethnicity stratification and patient experience.
Miranda Wirtz reviewed three candidate access indicators for the 2026 snapshot: (1) the Bice‑Boxerman continuity index (proportion of patients with two or more primary care visits who received consistent care from the same provider), (2) primary care visits per 1,000 people (HPD claims), and (3) adults with a routine checkup in the past 12 months (CHIS survey). "We were planning to have this be a threshold, 0.7 being the kind of threshold that is often used to kind of separate good from not so good continuity," Debbie Lindes said.
Participants debated the tradeoffs. Alyssa Phyllis clarified that the continuity index is a patient‑level measure and staff intend to report the proportion of patients with scores above the threshold; Kevin and others emphasized that claims‑based measures can undercount certain clinician roles and that CHIS self‑reported routine checkup data enables race/ethnicity stratification that HPD lacks. Several attendees recommended reporting both an HPD visit measure and the CHIS routine checkup measure if space allows to preserve both claims validity and equity stratifications.
Staff said the HPD (all‑payer claims) denominators vary across measures and that some stratifications will not be available for 2026; they will continue to explore methods for additional disaggregation for future snapshots.
