The relationship between organizational culture and practice systems in primary care.

The patient-centered medical home is an approach to comprehensive primary care relying on well-developed systems. Research has shown that for practices to meet patient-centered medical home requirements, care models may need to be redesigned. However, there is a dearth of information about what factors are important to achieve this goal.

Development and testing of performance measures for pharmacy services.

Objective: To report on the status of the pilot work of PQA, a pharmacy quality alliance, to develop and test performance metrics of pharmacy services for use in quality improvement, benchmarking, and pay-for-performance benchmarks.

Design: Observational cohort study.

Setting: Three health plans (commercial, Medicare and Medicaid) located in the northeastern United States and one nationwide prescription drug plan.

Benchmarking physician performance: reliability of individual and composite measures.

Objective: To examine the reliability of quality measures to assess physician performance, which are increasingly used as the basis for quality improvement efforts, contracting decisions, and financial incentives, despite concerns about the methodological challenges.

Study Design: Evaluation of health plan administrative claims and enrollment data.

Methods: The study used administrative data from 9 health plans representing more than 11 million patients.