Independent Practice Associations And Physician-Hospital Organizations Can Improve Care Management For Smaller Practices
- Lawrence P. Casalino ( [email protected] ) is the Livingston Farrand Associate Professor and chief of the Division of Outcomes and Effectiveness Research in the Department of Public Health, Weill Cornell Medical College, in New York City.
- Frances M. Wu is a doctoral candidate in the Health Services and Policy Analysis Program at the School of Public Health, University of California, Berkeley.
- Andrew M. Ryan is an associate professor of public health at Weill Cornell Medical College.
- Kennon Copeland is senior vice president and director for statistics and methodology at the National Opinion Research Center, in Bethesda, Maryland.
- Diane R. Rittenhouse is an associate professor in the Department of Family and Community Medicine and the Center for Excellence in Primary Care at the University of California, San Francisco.
- Patricia P. Ramsay is a research specialist in the School of Public Health at the University of California, Berkeley.
- Stephen M. Shortell is dean of and a professor in the School of Public Health at the University of California, Berkeley.
Pay-for-performance, public reporting, and accountable care organization programs place pressures on physicians to use health information technology and organized care management processes to improve the care they provide. But physician practices that are not large may lack the resources and size to implement such processes. We used data from a unique national survey of 1,164 practices with fewer than twenty physicians to provide the first information available on the extent to which independent practice associations (IPAs) and physician-hospital organizations (PHOs) might make it possible for these smaller practices to share resources to improve care. Nearly a quarter of the practices participated in an IPA or a PHO that accounted for a significant proportion of their patients. On average, practices participating in these organizations provided nearly three times as many care management processes for patients with chronic conditions as nonparticipating practices did (10.4 versus 3.8). Half of these processes were provided only by IPAs or PHOs. These organizations may provide a way for small and medium-size practices to systematically improve care and participate in accountable care organizations.