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Advanced Primary Care Clinic outcomes

  • 2016 outcomes

    Courage Kenny Advanced Primary Care Clinic demonstrates that excellent primary care can improve a person’s health and health care experiences, reduce hospitalizations, and lower health care costs. The Advanced Primary Care Clinic is a state-certified medical home where people are managed by a team of health care professionals. On average people served have 80% fewer hospital days after enrolling in the clinic, and the average number of days spent in the hospital each year for each person drops from 11.6 days to 2.3 days. We estimate this lowers hospital costs by an average of $1,706 per person per month.


    In 2016, Courage Kenny Advanced Primary Care Clinic served 313 people. 

    APC Age of Clients chart 2016

    APC Race of Clients 2016

    APC Health Insurance providers chart 2016


    The measures used to determine the impact of the Advanced Primary Care Clinic on each person’s outcomes include:

    • Patient Health Questionnaire-9 (PHQ-9): a clinical tool that is used to screen for depression
    • Patient Activation Measure (PAM): a measure of the person’s skills, knowledge, and confidence in taking an active role in maintaining his or her health 
    • Healthy Days: a measure where a person reports the number of days in which their “physical health” and “mental health” are not good over the last 30 days


    In 2016, 73% of people with moderate to severe depression improved during the year. 

    APC Improvement in patients with depression chart 2016

    Patient activation

    The Patient Activation Measure (PAM) measures four levels of activation: “(1) disengaged and overwhelmed, (2) becoming aware but still struggling, (3) taking action, (4) maintaining behaviors and pushing further”[i]. Sixty-one percent of people who scored at levels 1, 2 or 3 at the beginning of the year, improved throughout the year. "Each point increase in PAM score correlates to a 2% decrease in hospitalization and 2% increase in medication adherence"[i].

    APC percent who improved chart 2016

    Healthy days

    For those who reported less than 15 healthy days at enrollment, the average number of healthy days increased from 1.1 to 11 after one year. This increase of almost 10 days shows that overall people made gains in their health. 


    Courage Kenny Rehabilitation Institute has a data-sharing agreement with the Minnesota Department of Human Services that allows for the tracking of hospitalizations and emergency department visits for the clinic’s Medicaid-insured people before and after their enrollment in the clinic.

    Health care utilization data was collected for 224 Advanced Primary Care Clinic patients who have Minnesota Medicaid insurance. As of December 2016, the average hospitalization rate for this group was:

    • 11.6 days per year PRIOR to enrollment
    • 2.3 days per year AFTER enrollment

    On average, people had fewer hospitalizations after enrolling in the clinic, indicating improved or maintained health or better access to their primary care team. The difference equates to an 80% reduction in hospital days or an estimated hospital cost savings of $1,706 per Medicaid or dually-eligible client per month, which totals to $3.9 million for all Medicaid or dually-eligible clients for the year.

    [i] Insignia Health. (n.d.) Pam Survey

    For more information on outcomes, please call 612-775-2510. For more information about the Advanced Primary Care Clinic, please call 612-775-2600.