Table 3.
Change in Performance in Incentive and Control Groups for All Insurance Types
| Baseline Performance Adjusteda % (95%CI) | End of Study Performance Adjusteda % (95%CI) | Between Group Differences in Performance Change | |||||
|---|---|---|---|---|---|---|---|
| Controlb | Incentiveb | Controlb | Incentiveb | Absolute Adjusteda Change in Incentive – Change in Control (95%CI) | Adjusteda Odds Ratio, Interaction Term for Study Group and Study Year (95%CI)c | P valuec | |
| Aspirin therapy, with IVD or DM | 54.4% (47.6–61.2) | 52.6% (46.0–59.1) | 60.5% (54.0–67.0) | 64.6% (58.7–70.5) | 6.0% (2.2–9.7%) | 1.28 (1.10–1.50) | 0.001 |
| BP control, no IVD or DM | 31.8% (20.6–43.1) | 52.1% (40.2–64.0) | 36.1% (24.1–48.0) | 61.8% (50.5–73.0) | 5.5% (1.6–9.3%) | 1.23 (1.05–1.44) | 0.01 |
| BP control, with IVD | 46.0% (31.1–60.7) | 68.4% (55.7–81.2) | 57.3% (43.1–71.5) | 70.8% (59.5–82.2) | −9.1% (−22.1–3.9%) | 0.71 (0.40–1.24) | 0.23 |
| BP control, with DM | 10.4% (5.8–15.0) | 16.8% (10.4–23.3) | 11.6% (6.6–16.6) | 25.8% (17.4–34.4) | 7.8% (3.2–12.4%) | 1.52 (1.12–2.07) | 0.007 |
| BP control, with IVD or DM | 16.9% (10.2–23.6) | 28.9% (19.8–38.0) | 18.6% (11.5–25.7) | 38.4% (28.2–48.6) | 7.8% (3.0–12.6%) | 1.37 (1.07–1.75) | 0.01 |
| Cholesterol control | 90.5% (88.6–92.5) | 91.4% (89.4–93.3) | 92.0% (90.6–93.4) | 91.6% (90.1–93.1) | −1.2% (−3.2–0.7%) | 0.86 (0.67–1.09) | 0.22 |
| Smoking cessation interventiond | 19.1% (12.5–25.7) | 17.1% (11.1–23.2) | 26.8% (18.6–35.0) | 29.5% (21.0–38.1) | 4.7% (−0.3–9.6%) | 1.30 (1.04–1.63) | 0.02 |
BP: Blood Pressure; IVD: ischemic vascular disease; HTN: hypertension; DM: diabetes mellitus.
All values are adjusted for clustering within clinics using mixed effects logistic regression modeling. Unadjusted values and numerators and denominators are in eTable 1. The statistical model creates odds ratios and we change this to more easily interpretable adjusted percentages using the predicted estimates from the model. The p-values in the last column indicate whether the effects are statistically significant.
Baseline rates differed between control vs. intervention practices (p<0.05) for blood pressure control, no comorbidities, blood pressure control in patients with IVD, and blood pressure control for IVD or DM.
Odds ratios and p-values for the interaction term of study group and study year, with odds ratios >1 indicating that the incentive group had greater improvement compared to baseline than the control group and odds ratios <1 indicating that the control group had greater improvement compared to baseline than the incentive group. P-values of <0.05 considered statistically significant.
Smoking cessation interventions measure: For patients ages 18 years or older identified as current smokers, receipt of cessation counseling, referral for counseling, or prescription or increase dose of a cessation aid, documented in the EHR.