National Study of Physician Organizations

and the Management of Chronic Illness

Home

Study Team

Funding

Publications

Instruments

Links

Contact Us

nspo@berkeley.edu

Last Updated February 24, 2006

This study examines the relationship between physicians' practice organizations and the likelihood that they have implemented care management practices, focusing on four chronic disease conditions - asthma, congestive heart failure, depression, and diabetes. The term "care management practices" is used to include the implementation of evidence-based clinical practice guidelines, protocols and pathways, case and care management systems, disease management programs, and demand management programs. This study has three specific aims.

(1) To create a national database on physician organizations (both group practices and independent practice associations - IPAs) of 20 doctors or more. Survey data will be collected on practice size, ownership, type, and volume of patients seen; management and governance of the organization; compensation models; relationships with health plans; and implementation of care management practices and quality improvement approaches - with a specific focus on the four key chronic illnesses.

(2) To use the above database to examine the relationships among physician practice organization and the implementation of care management and quality improvement practices.

(3) To gather more in-depth information and understanding from about 24 physician organizations about the governance and management of the physician organization, their relationships with health plans; and, in particular, the barriers and facilitators associated with the implementation of care management and quality improvement practices. The information obtained from the site visits and phone interviews will be used to provide greater understanding of the factors involved in changing clinical practice and to identify "better" practices that can be disseminated to the field. Overall this study will provide physician organizations and researchers important comparative data and information on governance and management, relationships with health plans, degree of risk assumption, compensation models, and the management of chronic illness.