Advanced Primary Care Clinic outcomes

2017 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 healthcare professionals. On average people served have 78% 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 12 days to 2.7 days. We estimate this lowers hospital costs by an average of $1,723 per person per month.


 In 2017, Courage Kenny Advanced Primary Care Clinic served 282 people.

 Age of persons served chart for Advanced Primary Care Clinic 2017 

Race of persons served chart for Advanced Primary Care Clinic 2017

Health insurance providers chart for Advanced Primary Care Clinic 2017


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. 



In 2017, 69% of people with moderate to severe depression improved during the year. 

Depression scores - APC 2017

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]. Forty-nine 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].

Percent who improved chart - APC 2017



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.

Healthcare utilization data was collected for 198 Advanced Primary Care Clinic patients who have Minnesota Medicaid insurance. As of December 2017, the average hospitalization rate for this group was:

  • 12.0 days per year PRIOR to enrollment
  • 2.7 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 78% reduction in hospital days or an estimated hospital cost savings of $1,723 per Medicaid or dually-eligible people per month, which totals to $4 million for all Medicaid or dually-eligible people for the year.


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

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