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Health Serv Res. 2018 Jun;53(3):1851-1869. doi: 10.1111/1475-6773.12693. Epub 2017 Apr 6.

A Two-Step Method to Identify Positive Deviant Physician Organizations of Accountable Care Organizations with Robust Performance Management Systems.

Author information

1
School of Public Health - Health Policy and Management, University of California, Berkeley, CA.
2
Division of Research, Kaiser Permanente Northern California, Oakland, CA.

Abstract

OBJECTIVE:

To identify positive deviant (PD) physician organizations of Accountable Care Organizations (ACOs) with robust performance management systems (PMSYS).

DATA SOURCE:

Third National Survey of Physician Organizations (NSPO3, n = 1,398).

STUDY DESIGN:

Organizational and external factors from NSPO3 were analyzed.

DATA COLLECTION/EXTRACTION METHODS:

Linear regression estimated the association of internal and contextual factors on PMSYS. Two cutpoints (75th/90th percentiles) identified PDs with the largest residuals and highest PMSYS scores.

PRINCIPAL FINDINGS:

A total of 65 and 41 PDs were identified using 75th and 90th percentiles cutpoints, respectively. The 90th percentile more strongly differentiated PDs from non-PDs. Having a high proportion of vulnerable patients appears to constrain PMSYS development.

CONCLUSIONS:

Our PD identification method increases the likelihood that PD organizations selected for in-depth inquiry are high-performing organizations that exceed expectations.

KEYWORDS:

Healthcare organizations and systems; health policy/politics/law/regulation; incentives in health care; information technology in health; quality improvement/report cards (interventions); quality of care/patient safety (measurement)

PMID:
28384376
PMCID:
PMC5980166
DOI:
10.1111/1475-6773.12693

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