Table 2.
Baseline Practice Characteristics, Overall and by Exemplar and Non-exemplar Practices
| All practices N = 211 |
Non-exemplar N = 139 |
Exemplar N = 39 |
p value* | |
|---|---|---|---|---|
| % or mean (SD) | % or mean (SD) | % or mean (SD) | ||
| Practice size (number of clinicians) | 3.5 (2.6) | 3.41 (2.97) | 3.79 (3.01) | 0.4004 |
| Geographic area | ||||
| Rural | 28.9% | 31.7% | 23.1% | 0.301 |
| Urban/suburban | 71.1% | 68.4% | 76.9% | |
| System for empanelment | 78.2% | 78.4% | 82.1% | 0.621 |
| “Meaningful use” stage 1 participation (yes) | 67.8% | 66.2% | 66.7% | 0.955 |
| Previous work with support organization (yes) | 65.4% | 61.9% | 74.4% | 0.15 |
| Accountable care organization member (yes) | 47.4% | 41.0% | 56.4% | 0.087 |
| Practice ownership | ||||
| Clinician | 47.9% | 52.2% | 28.2% | < 0.001 |
| Hospital/academic center | 15.6% | 12.2% | 2.6% | |
| Federally Qualified Health Center or similar | 36.5% | 35.3% | 69.2% | |
| Payers (% of patients covered) | ||||
| Commercial | 37.55 (25.23) | 38.05 (24.74) | 24.29 (3.88) | 0.005 |
| No insurance | 11.21 (13.89) | 11.28 (14.37) | 17.04 (14.31) | 0.035 |
| Medicaid | 27.43 (22.08) | 25.58 (18.73) | 41.48 (25.54) | < 0.001 |
| Medicare | 18.74 (13.99) | 19.74 (17.18) | 15.91 (20.30) | 0.164 |
| Underserved designation | 45.0% | 45.3% | 69.2% | 0.008 |
| Registries | ||||
| Risk | 35.1% | 33.8% | 53.9% | 0.023 |
| Diabetes | 64.0% | 60.4% | 76.9% | 0.058 |
| Cholesterol | 44.6% | 46.0% | 66.7% | 0.023 |
| Hypertension | 54.0% | 55.4% | 71.8% | 0.066 |
| Ischemic vascular disease | 37.9% | 29.5% | 61.5% | < 0.001 |
| Prevention | 53.6% | 48.9% | 66.7% | 0.05 |
| Number of registries | 2.89 (2.38) | 2.74 (2.42) | 3.97 (2.47) | 0.006 |
| Adoption of CVD clinical guidelines for prevention | ||||
| Posted | 26.4% | 22.3% | 41.0% | 0.019 |
| Agreed upon | 54.5% | 54.0% | 56.4% | 0.786 |
| EHR prompt | 59.6% | 51.1% | 89.7% | < 0.001 |
| Standing orders | 30.3% | 25.2% | 48.7% | 0.005 |
| Adoption of CVD clinical guidelines for management | ||||
| Posted | 32.7% | 24.5% | 41.0% | 0.042 |
| Agreed upon | 55.5% | 48.9% | 59.0% | 0.267 |
| EHR prompt | 56.4% | 49.6% | 84.6% | < 0.001 |
| Standing orders | 29.9% | 22.3% | 38.5% | 0.042 |
| Sum of above | 1.74 (1.37) | 1.45 (1.22) | 2.23 (1.35) | < 0.001 |
| PCMH recognized | 44.6% | 43.2% | 74.4% | < 0.001 |
| Practice survey “building blocks” | ||||
| Quality improvement team meets regularly | 2.41 (1.46) | 2.19 (1.46) | 3.00 (1.06) | 0.002 |
| System for empanelment | 2.07 (1.43) | 1.97 (1.41) | 2.64 (1.38) | 0.012 |
| Patient experience survey to monitor performance | 2.43 (1.60) | 2.24 (1.97) | 3.13 (1.36) | 0.002 |
| Patients provided with resources to manage health | 2.47 (1.11) | 2.32 (2.13) | 2.97 (0.85) | 0.001 |
| Strategies to improve CVD care (from the Change Process Capability Questionnaire) | ||||
| Total score | 7.12 (12.58) | 4.97 (12.79) | 13.36 (8.80) | < 0.001 |
| Information and skills training | 3.85 (0.97) | 3.68 (1.00) | 4.24 (0.68) | 0.002 |
| Opinion leaders, role modeling to encourage support for changes | 3.39 (1.18) | 3.27 (1.20) | 3.42 (1.18) | 0.524 |
| Systems to provide high-quality care | 3.94 (1.07) | 3.83 (1.08) | 4.33 (0.87) | 0.008 |
| Remove/reduce barriers | 3.82 (1.05) | 3.72 (1.11) | 4.03 (0.75) | 0.113 |
| Teams for change process | 3.72 (1.21) | 3.57 (1.22) | 4.11 (0.97) | 0.014 |
| Delegating to non-clinicians | 3.30 (1.34) | 3.18 (0.12) | 3.61 (1.38) | 0.089 |
| Power to authorize and make change | 3.58 (1.08) | 3.54 (1.10) | 3.50 (0.91) | 0.854 |
| Periodic measurement | 3.63 (1.20) | 3.44 (1.24) | 4.27 (0.69) | < 0.001 |
| Reporting practice performance | 3.50 (1.43) | 3.24 (1.43) | 4.47 (0.92) | < 0.001 |
| Goals and benchmarking | 3.46 (1.48) | 3.23 (1.47) | 4.42 (1.06) | < 0.001 |
| Customize implementation of CVD prevention care changes to practice | 3.22 (1.36) | 3.04 (2.81) | 3.84 (3.45) | 0.001 |
| Rapid-cycling, piloting, pre-testing | 2.89 (1.26) | 2.72 (1.23) | 3.47 (1.02) | 0.001 |
| Design improvements for less clinician work | 2.21 (1.23) | 3.07 (1.21) | 3.69 (1.09) | 0.006 |
| Designing improvements more beneficial to patients | 3.56 (1.20) | 3.39 (1.20) | 3.89 (1.05) | 0.022 |
| Implementation tracking note “building blocks” (rated by practice facilitator) | ||||
| Engaged leadership | 45.08 (23.84) | 44.30 (25.03) | 47.95 (18.94) | 0.398 |
| Data-driven improvement | 37.73 (27.57) | 39.23 (26.98) | 32.31 (29.33) | 0.167 |
| Empanelment | 66.30 (40.44) | 63.73 (41.39) | 75.64 (36.04) | 0.104 |
| Team-based care | 48.69 (32.15) | 47.62 (31.30) | 52.56 (35.26) | 0.397 |
| Patient-team partnership | 32.04 (22.31) | 27.93 (19.50) | 47.01 (25.54) | < 0.001 |
| Population management | 36.19 (32.05) | 32.04 (29.91) | 51.28 (35.33) | < 0.001 |
CVD cardiovascular disease, EHR electronic health record, PCMH patient-centered medical home
*Italic text indicates significance with p value of less than 0.05 at 95% confidence interval