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Use of Care Management Practices in Small‐ and Medium‐Sized Physician Groups: Do Public Reporting of Physician Quality and Financial Incentives Matter?
Author(s) -
Alexander Jeffrey A.,
Maeng Daniel,
Casalino Lawrence P.,
Rittenhouse Diane
Publication year - 2013
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2012.01454.x
Subject(s) - incentive , business , data collection , quality (philosophy) , sample (material) , survey data collection , public economics , actuarial science , marketing , economics , philosophy , chemistry , mathematics , epistemology , chromatography , microeconomics , statistics
Objective To examine the effect of public reporting ( PR ) and financial incentives tied to quality performance on the use of care management practices ( CMP s) among small‐ and medium‐sized physician groups. Data Survey data from T he N ational S tudy of S mall and M edium‐sized P hysician P ractices were used. Primary data collection was also conducted to assess community‐level PR activities. The final sample included 643 practices engaged in quality reporting; about half of these practices were subject to PR . Study Design We used a treatment effects model. The instrumental variables were the community‐level variables that capture the level of PR activity in each community in which the practices operate. Findings (1) PR is associated with increased use of CMP s, but the estimate is not statistically significant; (2) financial incentives are associated with greater use of CMP s; (3) practices' awareness/sensitivity to quality reports is positively related to their use of CMP s; and (4) combined PR and financial incentives jointly affect CMP use to a greater degree than either of these factors alone. Conclusion Small‐ to medium‐sized practices appear to respond to PR and financial incentives by greater use of CMP s. Future research needs to investigate the appropriate mix and type of incentive arrangements and quality reporting.