Table 3. Changes in Primary Care Accessibility and Select Practice Capabilities Between 2017 and 2022, Stratified by Accountable Care Organization (ACO) Participation.
| Domain | No ACO participation (n = 68) | Joined ACO between surveys (n = 107) | All other ACO participation (n = 486) | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Survey years | Adjusted difference (95% CI)a | Survey years | Adjusted difference (95% CI)a | Survey years | Adjusted difference (95% CI)a | ||||
| 2017-2018 | 2022-2023 | 2017-2018 | 2022-2023 | 2017-2018 | 2022-2023 | ||||
| Accessibility, weighted % of respondents | |||||||||
| Offer extended hoursb | 38 | 34 | 4 (−22 to 13) | 61 | 50 | −10 (−25 to 5) | 65 | 55 | −11 (−17 to −4) |
| Offer weekend visits | 18 | 20 | 5 (−20 to 30) | 57 | 26 | −31 (−44 to −17) | 47 | 27 | −18 (−24 to −13) |
| Select practice capability composite scores, mean on 100-point scale | |||||||||
| Average capability score (excluding access) | 41 | 45 | 4 (−3 to 11) | 47 | 53 | 6 (−1 to 12) | 54 | 57 | 3 (0.4 to 6) |
| Behavioral health integration | 41 | 23 | −22 (−41 to 2) | 36 | 40 | 3 (−7 to 14) | 40 | 45 | 2 (−4 to 9) |
| Depression care processes | 59 | 61 | 3 (−8 to 14) | 62 | 74 | 13 (5 to 21) | 70 | 75 | 4 (0.9 to 8) |
| Care of patients with complex/high needs | 34 | 64 | 29 (21 to 36) | 46 | 55 | 9 (−2 to 19) | 49 | 63 | 14 (9 to 18) |
| Chronic disease management processes | 36 | 40 | 4 (−16 to 24) | 40 | 54 | 14 (0.5 to 27) | 59 | 56 | −4 (−10 to 2) |
a
Values may differ due to rounding. Adjusted for ACO participation and ownership. Accessibility adjusted differences are reported in percentage points.
b
Visits before 8 am or after 5 pm on weekdays.