title: Increased Use of Care Management Processes and Expanded Health Information Technology Functions by Practice Ownership and Medicaid Revenue.
abstract: Practice ownership and Medicaid revenue may affect the use of care management processes (CMPs) for chronic conditions and expansion of health information technology (HIT). Using a national cohort of medical practices, we compared the use of CMPs and HIT from 2006/2008 to 2013 by practice ownership and level of Medicaid revenue. Poisson regression models estimated changes in CMP use, and linear regression estimated changes in HIT, by practice ownership and Medicaid patient revenue, controlling for other practice characteristics. Compared with physician-owned practices, system-owned practices adopted a greater number of CMPs and HIT functions over time (p < .001). High Medicaid revenue (≥30.0%) was associated with less adoption of CMPs (p < .001) and HIT (p < .01). System-owned practices (p < .001) and community health centers (p < .001) with high Medicaid revenue were more likely than physician-owned practices with high Medicaid revenue to adopt CMPs over time. System and community health center ownership appear to help high Medicaid practices overcome CMP adoption constraints.
authors.affiliation: University of California, Berkeley, CA, USA hrod@berkeley.edu.
authors.forename: Hector P
authors.initials: HP
authors.lastname: Rodriguez
authors.affiliation: American Institutes for Research, Foster City, CA, USA.
authors.forename: Sean R
authors.initials: SR
authors.lastname: McClellan
authors.affiliation: University of California, Berkeley, CA, USA.
authors.forename: Salma
authors.initials: S
authors.lastname: Bibi
authors.affiliation: Weill Cornell Medical College, New York, NY, USA.
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Casalino
authors.affiliation: University of California, Berkeley, CA, USA.
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Ramsay
authors.affiliation: University of California, Berkeley, CA, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Shortell
mesh_terms: D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration / Q000706:statistics & numerical data*; D008484:Medicaid / Q000706:statistics & numerical data*; D008490:Medical Informatics / Q000458:organization & administration / Q000706:statistics & numerical data*; D010067:Ownership / Q000458:organization & administration / Q000706:statistics & numerical data; D020399:Practice Management / Q000191:economics / Q000458:organization & administration; D014481:United States; D035862:Vulnerable Populations / Q000706:statistics & numerical data
keywords: care management; community health centers; health information technology; organizational change; practice ownership