California physician organizations are more likely than their counterparts in other states to use care management processes for patients with chronic illness, according to a new report in Health Affairs.
The California organizations--both independent practice associations and group practices--are also more likely than the others to make money, suggesting that groups can perform evidence-based care without going into the red, the study concludes.
The study, published Wednesday on the Health Affairs Web site and funded by the California HealthCare Foundation, was conducted by researchers at the Department of Health Policy and Management at the University of California School of Public Health.
The research is based on telephone interviews with executives at 1,104 physician organizations with 20 or more physicians nationwide.
The study finds that the California organizations use 35% to 50% more care management processes than their counterparts in other states. The report says this holds true for all surveyed types of care management, including case management, disease registry, and feedback to physicians, and it also holds true for most types of disease studied--for asthma, congestive heart failure and diabetes--but not for depression.
The report also finds that:
- 63.8% of California groups surveyed reported making money in the most recently completed fiscal year, compared with 48.5% in other states.
- Two factors strongly related to care management implementation were higher levels of information technology capability--specifically, clinical IT--and more external incentives.
- California groups experience many more incentives than physician organizations elsewhere.
- California IPAs average more than 1.5 more administrative-IT-capability items than non-California IPAs.
- HMO penetration is much higher for both California IPAs (53%) and medical groups (50%) than for counterparts elsewhere (28.4% and 31.5%, respectively).
- California IPAs are much more likely to report patient satisfaction to outside organizations (36.2% vs. 18.4%).
- Hospitalists are used more often by California physician organizations than they are elsewhere.