Table 1 Domains and variables

Dependent variables

 Utilization

Number of primary care visits

Number of non-primary outpatient care (e.g., subspecialty care, behavioral health)

Number of prescription drug claims

Number of emergency department visits

Number of inpatient admissions

 Quality

Well-child visits for two age groups: 3–6 years old and 12–17 years old

Assessed based on CPT codes and ICD codes:

CPT codes: 99,381–99,384, 99,391–99,394

(CPT codes for well-child visits by age: 0–15 months = 99,381, 99,382, 99,391, 99,392; 3–6 years = 99,382, 99,383, 99,392, 99,393; 12–17 years = 99,384, 99,394)

ICD codes: V202, V700, V703, V705, V706, V708, V709

Avoidable or ambulatory care sensitive emergency department visits

Measured using an adaptation of the NYU/Billings algorithm for classifying ED utilization [15, 16]

Avoidable or ambulatory care sensitive hospital admissions

Measured using the Agency for Healthcare Research and Quality Pediatric Quality Indicators [17]

 Spending

Total amount calculated as a sum of payments from Medicaid and third-party payers

Amount for each category of utilization calculated as a sum of payments from Medicaid and third-party payers

Independent variable

 Health center or non-health center patient

Health center patients = individuals with more than half of primary care visits occurring at a health center*

Non-health center patients = individuals with less than or equal to half of all primary care visits occurring at a health center or no primary care visits at a health center*

Primary care visits

Identifying using provider specialty and procedure codes

CPT codes: 99,201–99205, 99,211–99,215, 99,381–99,387, 99,391–99,397

ICD codes: any

Health center setting

Determined using national provider identifier, claim type, and place of service in each claim