Table 3.
Experience and Capabilities of Medicare NSACO Respondents
| Is comprehensively engaged in patient care planning and continuous management (n = 70) | Is not comprehensively engaged in patient care planning and continuous management (n = 213) | P value of difference (chi2 test) | |
|---|---|---|---|
| Payment reform and collaboration experience | |||
| Bundled or episode-based payments experience | 34% | 34% | 0.957 |
| Patient-centered medical home experience | 89% | 83% | 0.281 |
| Pay for performance experience | 94% | 86% | 0.105 |
| Public reporting experience | 89% | 84% | 0.429 |
| Capitated commercial contracts experience | 46% | 47% | 0.902 |
| Other risk-bearing contracts experience | 60% | 57% | 0.686 |
| Previous close collaboration between participating organizations | 46% | 25% | 0.004 |
| Advanced capabilities in quality performance measurement and financial rewards | |||
| Actively monitors performance and provides clinician feedback | 71% | 42% | < 0.001 |
| Comprehensive and timely financial performance | 43% | 24% | 0.002 |
| Physician quality performance reported and shared | 78% | 71% | 0.250 |
| Physician cost performance reported and shared | 46% | 53% | 0.349 |
| One-on-one physician review and feedback | 62% | 63% | 0.921 |
| Individual physician financial incentives | 41% | 40% | 0.977 |
| Individual non-financial awards | 25% | 20% | 0.383 |
| Advanced capabilities in care management | |||
| Chronic care management process and programs | 71% | 23% | < 0.001 |
| Smooth transitions of care | 50% | 15% | < 0.001 |
| Assessing provider quality and cost | 40% | 10% | < 0.001 |
| Integrated behavioral health programs | 31% | 6% | < 0.001 |
| Patient involvement in care decisions | 48% | 14% | < 0.001 |
| Established planning of end-of-life care | 41% | 12% | < 0.001 |
| Advanced capabilities in quality improvement | |||
| Use choosing wisely | 35% | 25% | 0.144 |
| Use evidence-based guidelines | 97% | 98% | 0.793 |
| Program to reduce preventable hospital readmissions | 59% | 39% | 0.003 |
| Standardized processes and guidelines | 44% | 13% | < 0.001 |
| Engaged in programs to reduce ambulatory care sensitive admissions | 63% | 32% | < 0.001 |
| Assess inappropriate ED use | 60% | 38% | 0.002 |
| Using disease monitoring data | 76% | 46% | < 0.001 |
| Measuring patient satisfaction | 67% | 44% | 0.002 |
| Clinician training in QI methods | 48% | 21% | < 0.001 |
| Communication across care settings | 43% | 20% | 0.005 |
| Advanced capabilities in patient activation and engagement | |||
| Most PCPs trained in patient activation and engagement methods | 69% | 64% | 0.517 |
| Most PCPs work with patients to develop treatment plan | 79% | 71% | 0.238 |
| Most high-risk patients engage in care transition program | 80% | 72% | 0.201 |
| Most PCPs offer patients evidence-based decision aids | 80% | 67% | 0.041 |
| Offer all clinicians training in shared decision-making | 22% | 4% | 0.001 |
| Advanced capabilities in health information technology | |||
| Use of single EHR | 20% | 22% | 0.772 |
| Meaningful use of EHR by majority of PCPs | 59% | 55% | 0.681 |
| Can run predictive risk assessment and stratification | 47% | 35% | 0.093 |
ED emergency department, EHR electronic health record, NSACO National Survey of Accountable Care Organizations, PCP primary care practitioner, QI quality improvement