Table 3

Adjusted Mean Difference in Change Process Capability Questionnaire Strategies Scores by Practice Characteristics Among 1,181 Small to Medium-Size Primary Care Practices

Characteristic	Multivariable Final Model R²= 22.4% Adjusted Mean Difference
Practice characteristics
Practice ownership (Ref: clinician-owned)
Hospital/health system	−3.32^a
FQHC, RHC, IHS, federal^c	−1.49
Other, none^d	0.62
Missing	0.96
Location^e [Ref: urban core]
Large town	1.29
Rural area	0.65
Suburban	−2.13
Medically underserved area classification (Ref: No)
Yes	−1.52
Missing	1.46
External factors
Received external incentives in prior
12 mo (Ref: No)
Yes	0.96
Missing	−1.43
Participation in other demonstration projects^f (Ref: No)
Yes	1.24
Missing	3.10
Part of an accountable care organization (Ref: No)
Yes	2.74^a
Missing	2.23
Internal factors
Major disruption(s) in prior 12 mo^g (Ref: no disruption)
1 major disruption	−0.22
>1 major disruption	−2.68^b
Missing	0.33
Completely electronic EHR (Ref: No, part paper)
Yes	−3.59^b
Missing	−1.54
Produced quality report(s) in prior 6 mo (Ref: No)
Yes	5.09^a
Missing	2.96
Report CQMs at practice level (Ref: No)
Yes	2.21
Missing	5.09^b
Ability to create CQM reports from EHR (Ref: No ability)
In-house clinician or other staff	2.26^b
Outside service/consultant	0.76
Missing	0.18
Routinely discuss clinical quality data (Ref: Never)
Infrequently	1.87
Often	5.56^a
Not available, solo practice	4.40^b
Don’t know	3.81^b
Missing	4.21^b
Use of at least 1 registry (Ref: No)
Yes	3.74^a
Missing	2.22
Guidelines for CVD prevention or management^h (Ref: Not used or clinican agreement to use)
Included in EHR prompts or standing orders	4.45^a
Missing	0.41

AIC=Akaike Information Criterion; CQM=Clinical Quality Measure; CVD=cardiovascular disease; EHR = electronic health record; FQHC = federally qualified health center, IHS = Indian health services clinics; Ref = reference; RHC = rural health clinic; VA = Veterans Affairs.
Note: Final multivariable model was selected using backward model selection by the AIC. The model with the lowest AIC was preferred regardless of statistical significance for individual covariates.
↵a P value <.001.
↵b P value <.05.
↵c Includes FQHCs, RHCs, IHS, and VA, military, Department of Defense or other federally owned practices.
↵d Includes practices with nonfederal, private/nonclinician, academic, or tribal ownership, those indicating “other” without specifying an ownership type, and practices responding “no” to every ownership type.
↵e Location categories determined using rural-urban commuting area (RUCA) codes.
↵f Other demonstrations programs include State Innovation Models initiative, Comprehensive Primary Care Initiative, Transforming Clinical Practice Initiative, community health worker training program, Blue Cross Blue Shield Patient-Centered Medical Home program, and Million Hearts.
↵g Major disruptions include new EHR, new billing system, moved locations, staff turnover, and purchased/affiliated with larger organization.
↵h Guidelines for CVD prevention and management were combined to avoid multicollinearity. A practice was categorized as “Included in EHR prompts or standing orders” if they denoted that in either CVD prevention or CVD management or both.