Association Between Practice Participation in ACOs, Risk for Primary Care Costs, and Primary Care Physician Compensation (N = 628)
| Independent Variable | Percentage Point Change in Physician Compensation for Salary (95% CI) | Percentage Point Change in Physician Compensation for Quality (95% CI) |
|---|---|---|
| Does not participate in a CMS ACO program (reference) | … | … |
| Participates in a CMS ACO program | −3.5 (−12.0 to 4.9) | 2.2 (1.4 to 2.9)a |
| Does not take substantial risk for primary care costs (reference)b | … | … |
| Takes substantial risk for primary care costsb | 35.5 (8.5 to 62.5)c | −1.0 (−3.6 to 1.5) |
| Number of physicians in practice | −0.02 (−0.09 to 0.04) | −0.001 (−0.008 to 0.006) |
| Only primary care physicians (reference) | … | … |
| Multispecialty practice | −8.3 (−27.1 to 10.6) | −0.1 (−3.9 to 3.7) |
| Practice owned by hospital or health system (reference) | … | … |
| Practice owned by physicians | −8.3 (−15.4 to −1.1)c | −8.0 (−11.5 to −4.6)a |
| Practice owned by other groupd | −13.0 (−59.7 to 33.8) | −6.9 (−13.4 to −0.4)c |
| Percentage of patients whose primary language is not English | 0.5 (0.4 to 0.6)a | −0.04 (−0.09 to 0.01) |
ACO = accountable care organization; CMS = Centers for Medicare and Medicaid Services; HMO = health maintenance organization.
Note: Estimates are from linear regression models, incorporating the survey design.
↵a P <.01
↵b Defined by whether practices have some financial risk for all of their point-of-service patients.
↵c P <.05
↵d HMO or insurance entity, nonphysician managers, other.