Table 1.
Practice and Patient Characteristics by Ownership Type*
| Measure | Observations† | Physician-Owned Practices |
Health System/Medical Group Practices |
FQHC Practices |
||||
|---|---|---|---|---|---|---|---|---|
| Value | Value | Difference (95% Cl) | P Value | Value | Difference (95% Cl) | P Value | ||
| Practice demographics | ||||||||
| Ownership (Values showing %) | 989 | 53.2 | 25.6 | 21.2 | ||||
| Solo practice (Values showing %) | 966 | 45.0 | 8.1 | 36.9(−54.4 to −16.1) | <.001 | 12.8 | −32.2(−56.4 to −9.1) | .009 |
| Urban practice location (Values showing %) | 989 | 74.9 | 57.3 | 17.6(−48.9 to 1.0) | .16 | 46.7 | −28.2(−43.3 to −9.0) | .002 |
| Multispecialty practice (Values showing %) | 957 | 17.6 | 32.4 | 14.6(10.2 to 21.1) | <.001 | 56.3 | 38.7(28.3 to 53.0) | <.001 |
| Less than 5 years under current ownership (Values showing %) | 884 | 12.4 | 41.0 | 28.6(21.1 to 37.1) | <.001 | 16.9 | 4.5(−4.9 to 17.3) | .45 |
| At least one major change in last year (Values showing %) | 949 | 43.1 | 65.4 | 22.3(6.0 to 39.4) | .01 | 72.1 | 29.0(13.3 to 47.6) | .001 |
| Less than 5 years of EHR experience (Values showing %) | 869 | 33.3 | 46.3 | 13.0(−4.1 to 36.7) | .23 | 25.4 | 7.9(−4.2 to 19.1) | .47 |
| Practice patient demographics | ||||||||
| Patients receiving Medicaid (Values showing %) | 884 | 28.2 | 20.2 | 8.0(−15.9 to 1.6) | .08 | 40.4 | 12.2(0.8 to 22.9) | .03 |
| Patients receiving Medicare (Values showing %) | 885 | 23.0 | 28.7 | 5.7(1.4 to 11.2) | .02 | 15.3 | 7.7(−12.9 to −4.0) | <.001 |
| Non-white patients (Values showing %) | 851 | 45.2 | 42.4 | 2.8(−26.5 to 13.0) | .77 | 35.0 | 10.2(−24.1 to 7.0) | .2 |
| Hispanic/Latino patients (Values showing %) | 825 | 14.3 | 9.3 | 5.0(−13.1 to 22.) | .24 | 31.8 | 17.5(1.2 to 30.3) | .04 |
| Other external and internal foctors | ||||||||
| Have PCMH recognition (Values showing %) | 926 | 39.3 | 42.2 | 2.9(−17.0 to 16.7) | .73 | 66.5 | 27.2(4.0 to 46.0) | .01 |
| Participate in other demonstration programs (Values showing %) | 908 | 33.6 | 23.3 | 10.3(−29.3 to 4.4) | .22 | 35.2 | 1.6(−14.3 to 23.2) | .87 |
| Part of an ACO (Values showing %) | 937 | 41.7 | 56.6 | 14.9(−13.1 to 32.6) | .21 | 37.2 | −4.5(−25.6 to 14.8) | .66 |
| Have stage 1 and 2 certified EHR MU (Values showing %) | 874 | 72.9 | 66.8 | 6.1(−22.4 to 9.5) | .48 | 62.3 | −4.5(−25.6 to 14.8) | .66 |
| Burnout‡ (Values showing %) | 930 | 14.7 | 19.6 | 4.9(−0.1 to 11.9) | .11 | 19.4 | 4.7(−4.2 to 10.1) | .19 |
| No. of practices (Values showing numbers) | 989 | 526 | 253 | 210 | ||||
Based on practice surveys and practice member surveys of practices participating in EvidenceNOW, collected between October 2015 and April 2017.
The column “Observations” shows the number of practices with an observed value for the respective measure. Urban practice location is defined as percent of practices in urban locations based on Rural-Urban Commuting Areas using 2010 Census data. A major change includes the following: have moved to a new location, lost one or more clinicians, lost one or more office managers or head nurses, been purchased by or affiliated with a larger organization, new billing system, or another change specified by the practice. Demonstration programs include State Innovation Models Initiative, Comprehensive Primary Care Initiative, Transforming Clinical Practice Initiative—Support and Alignment Network, Community Health Worker training program, Blue Cross/Blue Shield patient-centered medical home program, Association of State and Territorial Health Officials’s Million Hearts State Learning Collaborative; Million Hearts: Cardiovascular Disease Risk Reduction Model, or another program identified by the practice.
The percent burned out denotes the percent of practice members who responded affirmative to one of the following items: level 3, I am definitely burning out and have one or more symptoms of burnout, such as physical and emotional exhaustion; level 4, the symptoms of burnout that I’m experiencing won’t go away; I think about frustrations at work a lot; level 5, I feel completely burned out and often wonder if I can go on practicing; I am at the point where I may need some changes.
CI, confidential interval; FQHC, Federally Qualified Health Center; EHR, electronic health records; PCMH, patient-centered medical home; MU, meaningful use; ACO, Accountable Care Organization.