1 / 16

A Tale of Two Physician Organization Ownership Types

A Tale of Two Physician Organization Ownership Types. Margaret C. Wang RAND/UCLA Post-Doctoral Fellow AcademyHealth Annual Research Meeting. Background. The “quality chasm” in health care Paradigm shift in chronic care delivery The crucial role of physician organizations (POs).

martin-spears
Télécharger la présentation

A Tale of Two Physician Organization Ownership Types

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A Tale of Two Physician Organization Ownership Types Margaret C. Wang RAND/UCLA Post-Doctoral Fellow AcademyHealth Annual Research Meeting AcademyHealth ARM

  2. Background • The “quality chasm” in health care • Paradigm shift in chronic care delivery • The crucial role of physician organizations (POs) AcademyHealth ARM

  3. PO Ownership Structures Why does it matter? • Freestanding physician-owned • System-affiliated hospital-owned “Who owns the equipment and employs the non-physician staff of your PO (including MSO, if any)?” AcademyHealth ARM

  4. Research Questions • What is the association between the type of PO ownership structure and: • Clinical IT, scheduling and follow-up capabilities, availability of case managers, and financial resources • External incentives for quality • How does ownership structure affect the implementation of the Chronic Care Model? AcademyHealth ARM

  5. The Chronic Care Model (CCM) Source: Wagner et al., 1999 AcademyHealth ARM

  6. The Chronic Care Management Index (CCMI) AcademyHealth ARM

  7. Data Source • National Study of Physician Organizations and the Management of Chronic Illnesses • National census of physician organizations employing 20 or more physicians (2000 –2001) • Final sample size = 1,104 (70% response rate) • 67% medical group and 33% IPAs AcademyHealth ARM

  8. Descriptive Statistics AcademyHealth ARM

  9. Organizational Resources • Mean values for structural and human resources: • Percentage of POs reporting breaking even vs. loss: AcademyHealth ARM

  10. Impact of External Incentives • Mean value for Quality Reporting Requirement Index: • Percentage of PO reporting receiving external incentives for quality: AcademyHealth ARM

  11. Implementation of the CCM • Mean and standard deviation for the Chronic Care Management Index (CCMI): AcademyHealth ARM

  12. Implementation of the CCM • Stepwise Multivariate Linear Regression: AcademyHealth ARM

  13. Implementation of the CCM • Sub-sample analyses: AcademyHealth ARM

  14. Conclusions • Ownership matters but organizational resources and external incentives are more important for CCM implementation • Receiving public recognition for quality • The role of clinical IT among the system-affiliated hospital-owned POs warrants further investigation AcademyHealth ARM

  15. Policy Implications Promoting greater implementation of the Chronic Care Model requires: • Organizational resources • Clinical IT, scheduling capabilities, active follow-up, and case manager availability • Incentive mechanisms • Requiring quality reporting, providing public recognition for quality, and tying quality improvement with better contracts AcademyHealth ARM

  16. Acknowledgements • Dissertation study was funded by Health Research and Education Trust (HRET) Fellowship • The NSPO project was funded by the Robert Wood Johnson Foundation (RWJF) AcademyHealth ARM

More Related