ArticleHealth services research2020
Health system affiliation of physician organizations and quality of care for Medicare beneficiaries who have high needs.
Article in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quality Indicators for High-Need Patients: a Systematic Review.Journal of general internal medicine · 2022Pooled it
- Community Characteristics Associated With Health System Penetration.Medical care research and review : MCRR · 2026Article
- Higher intensity care for patients with multiple chronic conditions after hospital-physician integration.Health affairs scholar · 2026Article
- Health System Expansion and Changes in Medicare Beneficiary Utilization of Safety Net Providers.Medical care · 2025Article
- Association between physician-hospital integration and inpatient care delivery in accountable care organizations: An instrumental variable analysis.Health services research · 2024Article
- A more complete measure of vertical integration between physicians and hospitals.Health services research · 2024Article
- The segregation of physician networks providing care to black and white patients with heart disease: Concepts, measures, and empirical evaluation.Social science & medicine (1982) · 2024Article
- Within-Physician Differences in Patient Sharing Between Primary Care Physicians and Cardiologists Who Treat White and Black Patients With Heart Disease.Journal of the American Heart Association · 2023Article
- Hospital-cardiologist integration often occurs without a practice acquisition.Health services research · 2022Article
- Health system affiliation of physician organizations and quality of care for Medicare beneficiaries who have high needs.Health services research · 2020Article
- Making integration work.Health services research · 2020Article
- Small Independent Primary Care Practices Serving Socially Vulnerable Urban Populations.Annals of family medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectiveTo test the hypothesis that health systems provide better care to patients with high needs by comparing differences in quality between system-affiliated and nonaffiliated physician organizations (POs) and to examine variability in quality across health systems. DATA SOURCES: 2015 Medicare Data on Provider Practice and Specialty linked physicians to POs. Medicare Provider Enrollment, Chain, and Ownership System (PECOS) and IRS Form 990 data identified health system affiliations. Fee-for-service Medicare enrollment and claims data were used to examine quality. STUDY
designThis cross-sectional analysis of beneficiaries with high needs, defined as having more than twice the expected spending of an average beneficiary, examined six quality measures: continuity of care, follow-up visits after hospitalizations and emergency department (ED) visits, ED visits, all-cause readmissions, and ambulatory care-sensitive hospitalizations. Using a matched-pair design, we estimated beneficiary-level regression models with PO random effects to compare quality of care in system-affiliated and nonaffiliated POs. We then limited the sample to system-affiliated POs and estimated models with system random effects to examine variability in quality across systems. PRINCIPAL
findingsAmong 2 323 301 beneficiaries with high needs, 52.3% received care from system-affiliated POs. Rates of ED visits were statistically significantly different in system-affiliated POs (117.5 per 100) and nonaffiliated POs (106.8 per 100, P < .0001). Small differences in the other five quality measures were observed across a range of sensitivity analyses. Among systems, substantial variation was observed for rates of continuity of care (90% of systems had rates between 70.8% and 89.4%) and follow-up after ED visits (90% of systems had rates between 56.9% and 73.5%).
conclusionsSmall differences in quality of care were observed among beneficiaries with high needs receiving care from system POs and nonsystem POs. Health systems may not confer hypothesized quality advantages to patients with high needs.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.