| Baseline | Pilot year 3 | P value* | |
|---|---|---|---|
| Performance feedback | Number of practices (%)** | ||
| Quality feedback to PCPs (N=21 practices) | 19 (90%) | 21 (100%) | 0.50 |
| Utilization or cost feedback to PCPs (N=23) | 19 (83%) | 18 (78%) | 0.99 |
| Monthly or more frequent meetings about quality (N=22) | 7 (32%) | 21 (95%) | <0.001 |
| Monthly or more frequent meetings about utilization (N=23 | 7 (30%) | 13 (56%) | 0.070 |
| Registry use | |||
| Registry of patients who are overdue for screening services (N=23) | 14 (61%) | 22 (96%) | 0.022 |
| Registry of patients who are overdue for chronic disease services (N=22) | 14 (63%) | 22 (100%) | 0.008 |
| Registry of patients who are out of target range for chronic disease laboratory values (N=23) | 15 (65%) | 23 (100%) | 0.008 |
| Registry of patients at high risk of disease complications or hospitalization (N=23 | 16 (70%) | 23(100%) | 0.016 |
| Care management | |||
| Care management for patients at high risk of disease complications or hospitalization (N=23) | 6 (26%) | 24 (100%) | <0.001 |
| Specially-trained non-physician staff who help patients better manage their diabetes (N=22) | 16 (73%) | 21 (95%) | 0.124 |
| Specially-trained non-physician staff who help patients better manage their asthma (N=22) | 9 (41%) | 20 (91%) | 0.007 |
| Routine assessment of self-management needs of chronically ill patients (N=23) | 5(22%) | 23 (100%) | <0.001 |
| Referral system for linking patients to community programs (N=22) | 6 (27%) | 11 (50%) | 0.267 |
| Breast cancer screening (N=23) | 9 (39%) | 22 (96%) | <0.001 |
| Cervical cancer screening (N=23) | 9 (39%) | 21 (91%) | <0.001 |
| Colorectal cancer screening (N=23) | 9 (39%) | 22 (96%) | <0.001 |
| Diabetes: hemoglobin A1c testing (N=23) | 16 (70%) | 22 (96%) | 0.031 |
| Diabetes: cholesterol testing (N=23) | 17 (74%) | 22 (96%) | 0.062 |
| Diabetes: eye examination (N=23) | 10 (43%) | 22 (96%) | <0.001 |
| Diabetes: nephropathy monitoring (N=23) | 9 (39%) | 21 (91%) | <0.001 |
| Other outreach systems | |||
| Outreach to patients after hospitalization (N=23) | 10 (43%) | 23 (100%) | <0.001 |
| Outreach to patients with no appointment in for an extended period (longer than clinically appropriate) (N=22) | 8 (36%) | 21 (95%) | <0.001 |
| Electronic health record capabilities | |||
| Patient medication lists (N=23) | 23 (100%) | 23 (100%) | 0.99 |
| Patient problem lists (N=23) | 23 (100%) | 23 (100%) | 0.99 |
| Consultation notes from specialists (N=23) | 21 (91%) | 20 (87%) | 0.99 |
| Hospital discharge summaries (N=23) | 21 (91%) | 22 (96%) | 0.99 |
| Electronic medication prescribing (N=23) | 22 (96%) | 23 (100%) | 0.99 |
| Electronic laboratory test ordering (N=23) | 11 (48%) | 20 (87%) | 0.004 |
| Electronic radiology test ordering (N=23) | 11 (48%) | 19 (82%) | 0.022 |
| Alerts if ordered tests are not performed (N=23) | 6 (26%) | 16 (70%) | 0.006 |
| Secure electronic messaging to and from patients (N=23) | 7 (30%) | 9 (39%) | 0.50 |
| Access | |||
| Weekend care offered regularly (N=22) | 6 (27%) | 8 (36%) | 0.50 |
| Evening care offered ≥2 nights per week (N=23) | 10 (43%) | 13(57%) | 0.45 |
| Appointments for new patients within 2 weeks (N=22) | 5(23%) | 4(18%) | 0.99 |
Abbreviations: NCQA, National Committee for Quality Assurance; NA, Not Applicable; PCP, primary care physician or clinician (including MDs, DOs, and NPs).
*
Liddell exact test.
**
Due to item nonresponse, denominators for percentages are not the same for all entries in the table.