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Observational Study
. 2020 Jun;35(6):1730-1735.
doi: 10.1007/s11606-020-05642-3. Epub 2020 Jan 23.

Association Between HEDIS Performance and Primary Care Physician Age, Group Affiliation, Training, and Participation in ACA Exchanges

Jill R Glassman  1 , David S P Hopkins  2 , M Kate Bundorf  3 , Robert M Kaplan  2 , Meera V Ragavan  2 , Alan Glaseroff  2 , Arnold Milstein  2
Affiliations
Observational Study

Association Between HEDIS Performance and Primary Care Physician Age, Group Affiliation, Training, and Participation in ACA Exchanges

Jill R Glassman et al. J Gen Intern Med. 2020 Jun.

Abstract

Background: There are a limited number of studies investigating the relationship between primary care physician (PCP) characteristics and the quality of care they deliver.

Objective: To examine the association between PCP performance and physician age, solo versus group affiliation, training, and participation in California's Affordable Care Act (ACA) exchange.

Design: Observational study of 2013-2014 data from Healthcare Effectiveness Data and Information Set (HEDIS) measures and select physician characteristics.

Participants: PCPs in California HMO and PPO practices (n = 5053) with part of their patient panel covered by a large commercial health insurance company.

Main measures: Hemoglobin A1c testing; medical attention nephropathy; appropriate treatment hypertension (ACE/ARB); breast cancer screening; proportion days covered by statins; monitoring ACE/ARBs; monitoring diuretics. A composite performance measure also was constructed.

Key results: For the average 35- versus 75-year-old PCP, regression-adjusted mean composite relative performance scores were at the 60th versus 47th percentile (89% vs. 86% composite absolute HEDIS scores; p < .001). For group versus solo PCPs, scores were at the 55th versus 50th percentiles (88% vs. 87% composite absolute HEDIS scores; p < .001). The effect of age on performance was greater for group versus solo PCPs. There was no association between scores and participation in ACA exchanges.

Conclusions: The associations between population-based care performance measures and PCP age, solo versus group affiliation, training, and participation in ACA exchanges, while statistically significant in some cases, were small. Understanding how to help older PCPs excel equally well in group practice compared with younger PCPs may be a fruitful avenue of future research.

Keywords: HEDIS performance measures; health care quality; physician age; physician characteristics; primary care.

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Conflict of interest statement

The authors declare that they do not have a conflict of interest.

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