Abstract A12: Evaluating physician network-based measures of care coordination through the lens of the patient experience

Abstract

Abstract There is significant promise in analyzing physician patient-sharing networks to construct indirect measures of care coordination by defining relationships between physicians based on shared patients. This approach has the potential to uncover how otherwise latent organizational aspects of health care systems impact patient outcomes. A key challenge to this approach is how the various measures used to describe these networks infer the complex realities of health care delivery. The extent of patient-sharing relationships within physician networks has been associated with care utilization, cost of care, and some measures of care quality. While this approach has been validated to signal true professional relationships between physicians from the physicians’ perspective, it is unknown whether these measures reflect patients’ perceptions of their own care coordination. The objective of this study is to evaluate the associations between network-based measures of care coordination and patient-reported experience measures. We linked three publicly available data sources released by Centers for Medicare and Medicaid Services (CMS) that include national data on physician patient sharing in 2015, physician participation in a group practice, and patient-reported quality performance for group practices based on responses to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey in 2016. The outcomes of interest were patient-reported experience measures reflecting “Between visit communication,” “Clinicians working together for your care,” and “Getting timely care, appointments, and information” (CAHPS). The predictor variables of interests were physician group practice density (the number of physician pairs who share patients adjusting for total number of physician pairs) and clustering (the extent to which sets of three physicians all share patients). There were 476 groups that had patient-reported measures available. Patients’ perception of “Clinicians working together for your care” was significantly positively associated with both physician group practice density (p=0.02) and clustering (p=0.006). Physician group practice clustering was also significantly positively associated with “Getting timely care, appointments, and information” (p=0.005). This work suggests that network-based measures of care coordination are associated with some patient-reported experience measures. Evaluating and intervening on patient-sharing networks may provide novel strategies for initiatives aimed at improving quality of care and the patient experience. Citation Format: Erika L. Moen, Julie P. Bynum. Evaluating physician network-based measures of care coordination through the lens of the patient experience [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr A12.