Physicians' reports of their experience with health plan care management practices

Objective: To determine the availability of care management practices in various practice settings, the degree to which physicians report that these practices are useful, and whether physicians' reports vary by their relationships with health plans. Study design: Cross-sectional survey. Participants: In 2001, we surveyed generalist and specialist physicians serving commercial, Medicaid, and Medicare patients. This report focuses on the responses of 2134 physicians (1252 generalists, 882 specialists) who contracted with independent practice associations and preferred provider organizations. Measures: Physicians were asked about the availability, accuracy, and usefulness of specified care management practices. The responses were analyzed according to their relationships with their health plan. Results: Generalists, physicians with a higher percentage of health plan patients, and physicians who reported that health plans sought their views were more likely to report that they used care management practices. The majority who used these practices found them somewhat or very useful. Guidelines and disease management were among the most commonly available and most highly rated care management practices. Physicians' ratings of the usefulness of practice reports were associated with their perceptions of the reports' accuracy and with whether health plans sought their views on other aspects of the care management process. Conclusion: The stronger a physician's relationship with a health plan, the more positive the physician's experience with care management practices and policies was. The concordance between the types of available practices and physicians' ratings suggests that health plans and physicians agree about how to improve the quality of care.