Table 3.
Physician Organization (PO) descriptions
| A | B | C | D | E | |
|---|---|---|---|---|---|
| Location | West Michigan | Mid-Michigan | Southeast Michigan | Southern Michigan | Southeast Michigan |
| Number of practices visited for data collection | 4 | 5 | 7 | 5 | 4 |
| Number of practices in pilot | 8 | 17 | 15 | 6 | 5 |
| Types of practices | Family Medicine (FM) | FM | FM & General Med/IM | FM & Internal Med (IM) | FM & IM |
| Size of practices | Small (3 providers) to large (13 providers) | Very small (single physician) to small (3 providers) | Small (3 providers) to very large (26 providers) | Very small (single physician) to large (11 providers) | Medium (7 providers) to very large (37 providers) |
| Practice ownership | Independent/ partner with PO | Independent/ Hospital-owned | University-owned | Independent/ Hospital-owned/partner with PO | Hospital-owned |
| Care Manager (CMgr) – Who? | Nurses and Medical Assistants | RNs called Health Navigators | FM: part-time RNs General Med/IM: PharmDs |
Nurses (RN, LPN) and Medical assistants | RNs hired specifically as case managers |
| CMgr location | Centralized at PO/In practice | Centralized at PO | In practice | Centralized at PO/In practice | In practice |
| Patient mix | Complex chronic disease patients; high diabetes prevalence | Focuses more on prevention with patients (weight loss, smoking cessation, stress management, etc.) vs. chronic conditions | FM: patients with chronic conditions such as diabetes, hypertension, etc. General Med/IM: complex chronic disease patients, elderly, patients with medication management issues |
High-risk patients (stratified high, med, low risk based on survey) | Complex chronic disease patients; non-compliant patients |
| General | CMgt in place for about 3 years due to previous grant; CMgrs attend PO learning collaborative meetings | Health navigators also function in a quality improvement role; Health navigators are able to communicate with providers via electronic medical record |
2 different models within PO: 1) FM: CMgt does not seem to be a top priority; 2) General med/ IM: Pharmacists and panel managers work closely together – team approach |
PO provides learning collaborative meetings-CMgrs receive education and are able to communicate with one another and share best practices | Highly integrated CMgt program; PO very supportive of CMgt |