Exhibit 1:
Characteristics of primary care practices that did or did not engage in transitional care management (TCM) or chronic care management (CCM), 2016
| Practices engaged in any TCM (%) | Practices engaged in any CCM (%) | |||
|---|---|---|---|---|
| Characteristic | Yes (n = 10,384) | No (n = 37,846) | Yes (n = 3,347) | No (n = 44,883) |
| Number of physicians | ||||
| 1 | 46.7 | 64.4 | 42.2 | 62.0 |
| 2–10 | 34.8 | 28.6 | 39.0 | 29.3 |
| 11 or more | 18.5 | 7.0 | 18.8 | 8.8 |
| Mean share of physicians in a practice who were primary care | 85.9 | 86.4 | 84.8 | 86.4 |
| Medicare beneficiaries per primary care physician | ||||
| First tertile (0–24) | 13.6 | 40.6 | 14.0 | 36.4 |
| Second tertile (>24–56) | 37.1 | 31.3 | 34.8 | 32.4 |
| Top tertile (>56) | 49.3 | 28.1 | 51.2 | 31.3 |
| Settinga | ||||
| Metropolitan | 81.8 | 83.3 | 81.9 | 83.1 |
| Micropolitan | 12.6 | 9.4 | 11.6 | 9.9 |
| Small town | 1.8 | 2.5 | 2.1 | 2.3 |
| Rural | 4.1 | 4.8 | 4.4 | 4.7 |
| Region | ||||
| Northeast | 23.7 | 20.5 | 18.2 | 21.4 |
| Midwest | 18.4 | 16.3 | 15.4 | 16.9 |
| South | 41.4 | 40.8 | 48.1 | 40.4 |
| West | 16.6 | 22.5 | 18.3 | 21.4 |
| Percent of nonwhite patients | ||||
| First tertile (0–7%) | 29.3 | 23.9 | 23.8 | 25.2 |
| Second tertile (>7–23%) | 38.3 | 30.5 | 38.4 | 31.7 |
| Top tertile (>23%) | 32.4 | 45.6 | 37.8 | 43.1 |
| Percent of dually enrolledb patients | ||||
| First tertile (0–8%) | 29.2 | 29.8 | 26.7 | 29.9 |
| Second tertile (>8–25%) | 39.7 | 30.5 | 38.1 | 32.1 |
| Top tertile (>25%) | 31.1 | 39.7 | 35.2 | 38.0 |
| Medicare ACO participationc | 23.7 | 12.4 | 24.5 | 14.1 |
| Uptake of other care management coded | 19.7 | 3.5 | 61.7 | 18.9 |
| Uptake of AWVe | 87.6 | 45.9 | 90.1 | 52.3 |
SOURCE Authors’ analysis of data 2016 for a 20 percent random sample of Medicare beneficiaries. NOTES Primary care practices are office-based practices (that is, practices with five or more evaluation and management visits) with at least one primary care physician. All differences between practices that engaged in any TCM or CCM versus those that did not engage were significant (adjusted p <0.001, based on chi-square tests for homogeneity across engaged and not engaged practices), except for mean share of physicians in a practice who were primary care for TCM (p = 0.117) and for CCM (p = 0.005) and setting for CCM (p = 0.140). Models were adjusted for all practice characteristics included in the exhibit.
Based on rural-urban commuting area codes from census data.
Dually enrolled in Medicare and Medicaid.
A practice was considered to be participating in an accountable care organization (ACO) if the majority of beneficiaries attributed to the practice belonged to a Medicare Shared Savings Program ACO or a Pioneer ACO.
In the TCM analysis, uptake of other care management code refers to practices that billed for at least one CCM in the same year. In the CCM analysis, uptake of other care management code refers to practices that billed for at least one TCM in the same year.
Uptake refers to practices that provided at least one annual wellness visit (AWV) in 2016.