title: Expectations outpace reality: physicians' use of care management tools for patients with chronic conditions.
abstract: Use of care management tools--such as group visits or patient registries--varies widely among primary care physicians whose practices care for patients with four common chronic conditions--asthma, diabetes, congestive heart failure and depression--according to a new national study by the Center for Studying Health System Change (HSC). For example, less than a third of these primary care physicians in 2008 reported their practices use nurse managers to coordinate care, and only four in 10 were in practices using registries to keep track of patients with chronic conditions. Physicians also used care management tools for patients with some chronic conditions but not others. Practice size and setting were strongly related to the likelihood that physicians used care management tools, with solo and smaller group practices least likely to use care management tools. The findings suggest that, along with experimenting with financial incentives for primary care physicians to adopt care management tools, policy makers might consider developing community-level care management resources, such as nurse managers, that could be shared among smaller physician practices.
authors.forename: Emily
authors.initials: E
authors.lastname: Carrier
authors.forename: James
authors.initials: J
authors.lastname: Reschovsky
mesh_terms: D001249:Asthma / Q000628:therapy; D002908:Chronic Disease / Q000191:economics / Q000628:therapy*; D019058:Community Networks; D003863:Depression / Q000628:therapy; D003920:Diabetes Mellitus / Q000628:therapy; D004059:Diffusion of Innovation; D004470:Economics, Medical / Q000458:organization & administration; D005194:Family Practice / Q000458:organization & administration*; D006123:Group Practice / Q000458:organization & administration; D019538:Health Care Surveys; D006276:Health Facility Size; D006291:Health Policy; D006295:Health Resources / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D007349:Insurance, Health, Reimbursement; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D008511:Medicine / Q000458:organization & administration*; D009718:Nurse Administrators / Q000706:statistics & numerical data*; D015279:Organizational Culture; D010346:Patient Care Management / Q000191:economics / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000458:organization & administration; D010816:Physician Incentive Plans; D011216:Practice Management, Medical / Q000458:organization & administration*; D010818:Practice Patterns, Physicians'; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration*; D011331:Private Practice / Q000458:organization & administration; D011787:Quality of Health Care; D012042:Registries; D017010:Reminder Systems / Q000706:statistics & numerical data; D014481:United States