Medical home capabilities of primary care practices that serve sociodemographically vulnerable neighborhoods.

Background: Under current medical home proposals, primary care practices using specific structural capabilities will receive enhanced payments. Some practices disproportionately serve sociodemographically vulnerable neighborhoods. If these practices lack medical home capabilities, their ineligibility for enhanced payments could worsen disparities in care.

Associations between structural capabilities of primary care practices and performance on selected quality measures.

Background: Recent proposals to reform primary care have encouraged physician practices to adopt such structural capabilities as performance feedback and electronic health records. Whether practices with these capabilities have higher performance on measures of primary care quality is unknown.

Objective: To measure associations between structural capabilities of primary care practices and performance on commonly used quality measures.

Readiness for the Patient-Centered Medical Home: structural capabilities of Massachusetts primary care practices.

Background: The Patient-Centered Medical Home (PCMH), a popular model for primary care reorganization, includes several structural capabilities intended to enhance quality of care. The extent to which different types of primary care practices have adopted these capabilities has not been previously studied.

Objective: To measure the prevalence of recommended structural capabilities among primary care practices and to determine whether prevalence varies among practices of different size (number of physicians) and administrative affiliation with networks of practices.

The impact of pay-for-performance on health care quality in Massachusetts, 2001-2003.

Pay-for-performance (P4P) has become one of the dominant approaches to improving quality of care, yet few studies have evaluated its effectiveness. We evaluated the impact on quality of all P4P programs introduced into physician group contracts during 2001-2003 by the five major commercial health plans operating in Massachusetts. Overall, P4P contracts were not associated with greater improvement in quality compared to a rising secular trend.

Does affiliation of physician groups with one another produce higher quality primary care?

Purpose: Recent reports have emphasized the importance of delivery systems in improving health care quality. However, few prior studies have assessed differences in primary care quality between physician groups that differ in size and organizational configuration. We examined whether larger physician group size and affiliation with networks of multiple groups are associated with higher quality of care.

The response of physician groups to P4P incentives.

Objectives: Despite substantial enthusiasm among insurers and federal policy makers for pay-for-performance incentives, little is known about the current scope of these incentives or their influence on the delivery of care. To assess the scope and magnitude of pay-for-performance (P4P) incentives among physician groups and to examine whether such incentives are associated with quality improvement initiatives.

Study Design: Structured telephone survey of leaders of physician groups delivering primary care in Massachusetts.

Assessment partnerships between managed care and public health: the Massachusetts experience.

This article explores factors that facilitate or impede data sharing and linkage collaborations between state public health agencies and managed care organizations (MCOs). The exploration is based upon a review of both recent literature and the four years' experience of the Massachusetts Health Assessment Partnership (MHAP). MHAP has undertaken six collaborative data sharing and linkage projects that have involved diverse topics and methods.

Immunization status among children newly enrolled in a health plan: a new frontier for quality measurement?

Background: The National Scientific Panel on Immunization Measurement Standards recently recommended that the assessment population for the childhood immunization measure of the Health Plan Employer Data and Information Set include 24-month-olds with > or = 6 months of continuous enrollment in a health plan. The current inclusion criterion is > or = 12 months of continuous enrollment. The new recommendation would expand the assessment population to include children with more recent enrollment.