National Study of Physician Organizations

and the Management of Chronic Illness

The National Study of Physician Organizations and the Management of Chronic Illness (NSPO) examines the relationship between physicians' practice organizations and the likelihood that they have implemented care management processes, focusing on four chronic disease conditions - asthma, congestive heart failure, depression, and diabetes. The term "care management processes" is used to include the implementation of evidence-based clinical practice guidelines, protocols and pathways, care management systems, disease management programs, and demand management programs. 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.

NSPO1

The first round of NSPO, known as NSPO1, began in 2000. NSPO1 had three specific aims:

(1) To create a national database on physician organizations (both medical groups and independent practice associations - IPAs) of 20 physicians or more. Survey data were 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. The national survey by which these data were collected was conducted September 2000 to September 2001. The public version of the data set is available from the Inter-University Consortium for Political and Social Research (ICPSR): see ICPSR Study No. 4455; Principal Investigator Stephen M. Shortell; persistent URL http://dx.doi.org/10.3886/ICPSR04455

(2) To use the above database to examine the relationships among physician organiz ation characteristics 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.

NSPO2

The second round of NSPO, known as NSPO2 repeated the national survey of medical groups and IPAs in order to assess the status of CMPs and preventive services use as well as their key drivers and the extent to which these factors have changed over time. The national survey was conducted March 2006 to March 2007.