Improving Chronic Illness Care

A Longitudinal Cohort Analysis of Large Physician Organizations

By: Shortell SM, Gillies R, Siddique J, Casalino LP, Rittenhouse D, Robinson JC and McCurdy RK

In: Medical Care, 47(9), pp.932-939

Publisher: Lippincott Williams & Wilkins

Published: September 2009

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  • Improving Chronic Illness Care

The use of organized chronic illness care management processes (CMPs) is discussed in this article. Cohort analysis of data from a national telephone survey conducted in 2000 and 2006 specifically looked at 369 medical groups and independent practice associations of 20 physicians or more who treat chronic illnesses such as asthma, congestive heart failure, depression and diabetes.

Information gathered included details on the practices’ ownerships, size, chronic illness CMPs usage, financial incentives, quality improvement involvement and use of electronic medical records.

Key Findings:

  • Between 2000 and 2006, the use of CMPs increased by 23 percent.
  • The largest number of processes was used for diabetes; the smallest for depression.
  • Providing financial rewards for quality to physician organizations appeared to be positively correlated with CMP usage.
  • Policies encouraging quality improvement measures also improve chronic illness care.

The use of CMPs in larger physician organizations will increase more quickly if financial incentives to improve quality are utilized. Public policies that promote both financial incentives and quality improvement initiatives will likely improve chronic illness care.

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Listed below is one grant that supported this project.

Grant Awarded to Amount
Tracking and understanding national improvements in chronic illness care University of California, Berkeley, School of Public Health (Berkeley, CA)
ID#: 051573
Stephen M. Shortell, Ph.D., M.P.H.
510-643-5346
shortell@berkeley.edu
Actual award: $1,399,873
May 2005 to April 2010

RWJF may have supported this project with other grants that are not listed.

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Quality-Based Payment for Medical Groups and Individual Physicians

By:
Robinson JC, Shortell SM, Rittenhouse DR, Fernandes-Taylor S, Gillies RR and Casalino LP

Publication date:
Summer 2009

Summary:
This survey on quality-based payment found that the prevalence of external performance bonuses paid by insurers to large medical groups is larger than the prevalence of performance bonuses paid by the medical groups to the primary care and specialist physicians.

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Financial Incentives, Quality Improvement Programs, and the Adoption of Clinical Information Technology

By:
Robinson JC, Casalino LP, Gillies R, Rittenhouse DR, Shortell SS and Fernandes-Taylor S

Publication date:
April 2009

Summary:
Various factors influence the adoption of clinical information technology in health service organizations. More than 500 medical groups and independent practice associations participated in this study. Detailed tabulations present findings related to a broad range...

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Measuring the Medical Home Infrastructure in Large Medical Groups

By:
Rittenhouse DR, Casalino LP, Gillies RR, Shortell SM and Lau B

Publication date:
September 10, 2008

Summary:
Using data from the 2006-2007 National Study of Physician Organizations, the authors examine the extent of adoption of medical home infrastructure components among large primary care and multispecialty medical groups and their association with medical group size and...

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