Table 3.
Primary Care Practice Attainment of Individual NCQA Elements, Stratified by Practice Size and Organizational Structure
| Percentage (95 Percent Confidence Interval) | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Practice Size | Organizational Structure | ||||||||
| NCQA Element | All Primary Care n = 60,859 | Solo/Partner n = 46,829 | Small Group n = 10,347 | Medium Group n = 2,919 | Large Group n = 764 | p-Value† | Single-Specialty n = 9,014 | Multi-Specialty n = 5,016 | p-Value†† |
| Patient tracking and registry functions | |||||||||
| Uses data system for basic patient information | 73.3 (66.9–78.8) | 71.2 (63.3–77.9) | 77.5 (69.2–84.2) | 87.7 (78.0–93.5) | 92.0 (82.4–96.6) | .002 | 82.2 (74.4–88.1) | 77.2 (65.2–85.9) | .062 |
| Has clinical data system with clinical data in searchable data fields | 35.5 (30.2–41.1) | 33.2 (27.0–40.1) | 39.6 (31.5–48.4) | 45.9 (35.3–56.8) | 78.9 (66.9–87.3) | <.001 | 39.5 (31.0–48.6) | 49.6 (36.6–62.7) | .051 |
| Uses paper or electronic- based charting tools to organize clinical information* | 31.2 (26.7–36.2) | 28.2 (22.7–34.5) | 37.3 (29.4–45.9) | 46.5 (35.3–58.1) | 77.1 (65.6–85.6) | <.001 | 39.7 (31.1–48.9) | 44.4 (32.1–57.3) | .025 |
| Uses data to identify important diagnoses and conditions in practice* | 29.4 (24.4–34.9) | 26.7 (21.0–33.3) | 35.7 (27.9–44.3) | 43.9 (33.8–54.5) | 51.2 (38.9–63.4) | .001 | 39.9 (32.0–48.3) | 34.7 (24.6–46.4) | .021 |
| Care management | |||||||||
| Generates reminders about preventive services for clinicians | 30.4 (25.5–35.8) | 28.4 (22.8–34.8) | 34.7 (27.0–43.3) | 39.6 (29.6–50.5) | 65.5 (53.8–75.6) | <.001 | 37.4 (29.0–46.8) | 37.2 (26.2–49.7) | .133 |
| Uses non-physician staff to manage patient care | 53.7 (48.7–58.6) | 52.8 (46.6–58.9) | 56.6 (47.8–64.9) | 57.2 (47.1–66.6) | 56.0 (43.5–67.8) | 0.848 | 57.5 (49.4–65.3) | 55.1 (43.5–66.1) | .665 |
| Conduct care management, including care plans, assessing progress, addressing barriers | 86.4 (79.8–91.0) | 85.7 (77.2–91.4) | 86.8 (79.6–91.7) | 90.4 (78.6–96.0) | 99.9 (99.4–1.00) | <.001 | 91.6 (84.1–95.7) | 83.8 (73.8–90.4) | .248 |
| Patient self-management support | |||||||||
| Actively support patient self- management* | 90.5 (86.1–93.6) | 90.1 (84.5–93.8) | 90.2 (83.2–94.4) | 96.9 (92.8–98.7) | 93.6 (86.2–97.2) | .103 | 92.3 (86.3–95.8) | 90.7 (79.1–96.2) | .787 |
| Electronic prescribing | |||||||||
| Uses electronic system to write prescriptions | 32.6 (28.2–37.4) | 30.1 (24.7–36.2) | 37.7 (30.5–45.4) | 45.9 (36.0–56.0) | 67.2 (55.6–77.0) | <.001 | 39.2 (31.5–47.5) | 44.2 (32.7–56.4) | .045 |
| Has electronic prescription writer with safety checks | 25.2 (20.9–30.1) | 23.6 (18.5–29.7) | 28.0 (21.2–36.0) | 34.3 (25.0–44.9) | 55.7 (43.3–67.4) | <.001 | 28.2 (21.8–35.6) | 35.5 (24.1–48.9) | .172 |
| Test tracking | |||||||||
| Tracks tests and identifies abnormal results systematically* | 35.9 (30.6–41.5) | 31.9 (25.4–39.2) | 47.6 (39.3–55.9) | 52.9 (42.7–62.8) | 72.0 (57.2–83.2) | <.001 | 47.6 (39.6–55.8) | 53.9 (41.8–65.5) | .004 |
| Uses electronic systems to order and retrieve tests and flag duplicate tests | 16.1 (12.9–19.9) | 13.8 (10.1–18.5) | 19.2 (13.6–26.4) | 35.1 (25.4–46.3) | 47.4 (34.0–61.1) | <.001 | 23.0 (17.4–29.8) | 25.3 (14.5–40.4) | .028 |
| Performance reporting and improvement | |||||||||
| Measures clinical and/ or service performance by physician or across the practice* | 23.9 (18.8–29.7) | 22.0 (15.9–29.8) | 28.2 (21.3–36.3) | 36.5 (27.5–46.5) | 28.6 (18.3–41.8) | .132 | 33.2 (25.9–41.3) | 24.4 (17.0–33.7) | .079 |
| Survey of patient's care experience | 20.6 (15.7–26.5) | 19.3 (13.4–26.8) | 25.1 (18.5–33.1) | 24.0 (16.3–33.8) | 28.6 (18.5–41.5) | .454 | 23.9 (17.2–32.2) | 27.0 (18.2–38.0) | .428 |
| Reports performance across the practice or by physician* | 9.1 (6.5–12.5) | 7.6 (4.7–12.1) | 11.5 (7.3–17.7) | 19.0 (12.0–28.7) | 36.5 (24.2–50.8) | <.001 | 12.7 (8.5–18.6) | 17.0 (10.7–25.8) | .070 |
*
NCQA “must pass” element.
†
p-value is for the comparison between solo/partnership, small, medium, and large group practices.
††
p-value is for the comparison between solo/partnership, single-specialty, and multi-specialty group practices.
NCQA, National Committee on Quality Assurance.