Table 2.

Adjusted Percentage-Point Difference Compared With Referent in Difficulty Obtaining Pediatric Behavioral Health Advice and Services

	Percentage-Point Differences in Difficulty Obtaining
	Medication Advice		Evidence-Based Psychotherapy		Family Based Treatment
	Coefficient (SE)	P Value	Coefficient (SE)	P Value	Coefficient (SE)	P Value
Practice ownership structure, independent as referent^{^a}
Medical group	10.1 (6.6)	.128	6.0 (4.9)	.221	12.3 (6.2)	.049
Simple system	5.5 (6.4)	.389	6.9 (5.6)	.219	6.3 (6.9)	.361
Complex system	13.4 (8.3)	.107	3.3 (3.8)	.387	13.0 (7.9)	.099
Practice size, very small (<4) as referent^{^b}
Small (4-9)	1.1 (4.8)	.817	0.6 (4.7)	.898	2.4 (4.5)	.590
Medium (10-19)	3.1 (4.4)	.480	–3.0 (4.2)	.476	–0.4 (4.1)	.932
Large (>20)	–0.2 (6.1)	.975	–6.5 (6.3)	.304	–3.6 (5.7)	.525
Practice has behavioral health expertise
General psychiatrist	–2.1 (7.1)	.768	3.6 (7.6)	.642	9.1 (7.4)	.219
Child psychiatrist	–12.3 (12.9)	.340	6.9 (12.6)	.586	–3.5 (7.8)	.653
General pediatrician	1.1 (4.3)	.796	1.8 (5.5)	.745	7.4 (5.1)	.143
Specialist pediatrician	0.4 (8.3)	.964	3.7 (5.8)	.527	1.3 (5.3)	.805
Practice oriented toward socially vulnerable populations
Federally qualified health center	0.01 (8.1)	.999	–5.0 (7.4)	.501	–6.5 (7.1)	.356
Share of revenue from Medicaid in top quartile across practices	–3.1 (4.2)	.466	–8.4 (4.0)	.036	–4.5 (4.1)	.270
Rural zip code	15.2 (5)	.002	11.7 (4)	.005	9.3 (4)	.021
Practice participation in delivery and payment reforms expected to influence pediatric behavioral health care
CMS Comprehensive Primary Care+	–8.5 (9.5)	.371	–6.3 (9.9)	.524	–6.9 (9.6)	.471
Medicaid ACO	–8.8 (3.8)	.021	–9.5 (3.4)	.006	–5.5 (3.4)	.107
Constant	79.4 (14.1)	<.001	89.0 (11.8)	<.001	97.4 (12.1)	<.001
	N		N		N
Practices	1,410		1,410		1,410
Systems	944		944		944

ACO = accountable care organization; CMS = Centers for Medicare and Medicaid Services.
↵^aOwnership structures: independent practices do not have any ownership relationships beyond the practice itself. Systems include medical group practices owned by an organization that owns other practices but no hospital, simple system practices owned by an organization that owns other practices and ≥1 hospital, and complex system practices owned by an organization that itself owns a medical group or another system (ie, a system within a system).
↵^bPractice size defined according to number of physicians.