PANEL SURVEY ESTIMATION IN THE PRESENCE OF LATE REPORTING AND NONRESPONSE

Estimates from economic panel surveys are generally required to be published soon after the survey reference period, resulting in missing data due to late reporting as well as nonresponse. Estimators currently in use make some attempt to correct for the impact of missing data. However, these approaches tend to simplify the assumed nature of the missing data and often ignore a portion of the reported data for the reference period. Discrepancies between preliminary and revised estimates highlight the inability of the estimation methodology to correct for all error due to late reporting. The current model for one economic panel survey, the Current Employment Statistics survey, is examined to identify factors related to potential model misspecification error, leading to identification of an extended model. An approach is developed to utilize all reported data from the current and prior reference periods, through missing data imputation. Two alternatives to the current models that assume growth rates are related to recent reported data and reporting patterns are developed, one a simple proportional model, the other a hierarchical fixed effects model. Estimation under the models is carried out and performance compared to that of the current estimator through use of historical data from the survey. Results, although not statistically significant, suggest the potential associated with use of reported data from recent time periods in the working model, especially for smaller establishments. A logistic model for predicting likelihood of late reporting for sample units that did not report for preliminary estimates is also developed. The model uses a combination of operational, respondent, and environmental factors identified from a reporting pattern profile. Predicted conditional late reporting rates obtained under the model are compared to actual rates through use of historical information for the survey. Results indicate the appropriateness of the parameters chosen and general ability of the model to predict final reporting status. Such a model has the potential to provide information to survey managers for addressing late reporting and nonresponse

Spending per Medicare Beneficiary Is Higher in Hospital‐Owned Small‐ and Medium‐Sized Physician Practices

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145215/1/hesr12765.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145215/2/hesr12765-sup-0001-AppendixSA1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145215/3/hesr12765_am.pd

Trends in hospital ownership of physician practices and the effect on processes to improve quality.

ObjectivesReports suggest a trend for physician practices to change ownership from physicians to hospitals. It remains unclear how this change affects quality of patient care. We report the effect of a change to hospital ownership on the use of care management processes (CMPs) and health information technology (IT) among practices in the United States.Study designTrend analyses of 3 large national surveys of physician practices.MethodsWe included 2 cohorts of practices: large practices with 20 or more physicians and small/medium practices with fewer than 20 physicians. The main outcomes were the changes in CMP and health IT indices among practices that were acquired by hospitals. We used multivariate logistic regression to assess these changes.ResultsLarge practices acquired by hospitals had larger increases in their CMP index than those that remained physician-owned (11.0-point increase vs 7.0-point decrease; adjusted P = .03). Small/medium practices acquired by hospitals had smaller but significantly higher increases in their CMP score (3.8 points vs 2.6 points; adjusted P = .04). Among all practices, there were no significant differences in the change of the health IT index.ConclusionsWe found a significant increase in the use of CMPs among practices that were acquired by hospitals and no difference in health IT use. These findings suggest that a trend for hospitals to own physician practices may have a positive effect on chronic disease management and quality of care

Physician Practice Participation in Accountable Care Organizations: The Emergence of the Unicorn

OBJECTIVE: To provide the first nationally based information on physician practice involvement in ACOs. DATA SOURCES/STUDY SETTING: Primary data from the third National Survey of Physician Organizations (January 2012–May 2013). STUDY DESIGN: We conducted a 40-minute phone survey in a sample of physician practices. A nationally representative sample of practices was surveyed in order to provide estimates of organizational characteristics, care management processes, ACO participation, and related variables for four major chronic illnesses. DATA COLLECTION/EXTRACTION METHODS: We evaluated the associations between ACO participation, organizational characteristics, and a 25-point index of patient-centered medical home processes. PRINCIPAL FINDINGS: We found that 23.7 percent of physician practices (n = 280) reported joining an ACO; 15.7 percent (n = 186) were planning to become involved within the next 12 months and 60.6 percent (n = 717) reported no involvement and no plans to become involved. Larger practices, those receiving patients from an IPA and/or PHO, those that were physician-owned versus hospital/health system-owned, those located in New England, and those with greater patient-centered medical home (PCMH) care management processes were more likely to have joined an ACO. CONCLUSIONS: Physician practices that are currently participating in ACOs appear to be relatively large, or to be members of an IPA or PHO, are less likely to be hospital-owned and are more likely to use more care management processes than nonparticipating practices

Physician Practice Participation in Accountable Care Organizations: The Emergence of the Unicorn

ObjectiveTo provide the first nationally based information on physician practice involvement in ACOs.Data sources/study settingPrimary data from the third National Survey of Physician Organizations (January 2012-May 2013).Study designWe conducted a 40-minute phone survey in a sample of physician practices. A nationally representative sample of practices was surveyed in order to provide estimates of organizational characteristics, care management processes, ACO participation, and related variables for four major chronic illnesses.Data collection/extraction methodsWe evaluated the associations between ACO participation, organizational characteristics, and a 25-point index of patient-centered medical home processes.Principal findingsWe found that 23.7 percent of physician practices (n = 280) reported joining an ACO; 15.7 percent (n = 186) were planning to become involved within the next 12 months and 60.6 percent (n = 717) reported no involvement and no plans to become involved. Larger practices, those receiving patients from an IPA and/or PHO, those that were physician-owned versus hospital/health system-owned, those located in New England, and those with greater patient-centered medical home (PCMH) care management processes were more likely to have joined an ACO.ConclusionsPhysician practices that are currently participating in ACOs appear to be relatively large, or to be members of an IPA or PHO, are less likely to be hospital-owned and are more likely to use more care management processes than nonparticipating practices