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Table 3 The Association of Reimbursement Composition and Hypertension and Diabetes Quality Indicators

From: Capitated versus fee-for-service reimbursement and quality of care for chronic disease: a US cross-sectional analysis

Reimbursement Composition

Controlled Hypertension (BP < 140/90) in Patients with Hypertensiona

% or aOR

(95% CI)

(N = 36,540)

p-value

Controlled Diabetes (HbA1c < 7%) in Patients with Diabetesb

% or aOR

(95% CI)

(N = 6016)

p-value

ACEi/ARB Use in Patients with Diabetes and Hypertension

% or aOR

(95% CI)

(N = 11,983)

p-value

Statin Use in Patients Age 40–75 with Diabetes

% or aOR

(95% CI)

(N = 10,985)

p-value

Unadjusted Prevalence

 Majority Capitation

71%

0.388

57%

0.586

54%

0.341

37%

0.431

 Majority FFS

74%

(ref.)

59%

(ref.)

50%

(ref.)

40%

(ref.)

 Other Revenue Mix

75%

0.499

63%

0.268

46%

0.131

32%

0.004

Model 1

 Majority Capitation

0.84 (0.60–1.18)

0.313

0.98 (0.65–1.49)

0.932

1.09 (0.81–1.46)

0.589

0.80 (0.54–1.20)

0.282

 Majority FFS (ref.)

1

–

1

–

1

–

1

–

 Other Revenue Mix

1.09 (0.89–1.33)

0.399

1.42 (1.01–2.00)

0.044

0.80 (0.60–1.07)

0.136

0.68 (0.50–0.90)

0.009

Model 2

 Majority Capitation

0.86 (0.65–1.15)

0.318

0.90 (0.59–1.38)

0.640

1.03 (0.74–1.44)

0.864

0.86 (0.59–1.25)

0.425

 Majority FFS (ref.)

1

–

1

–

1

–

1

–

 Other Revenue Mix

1.10 (0.90–1.34)

0.355

1.36 (0.98–1.90)

0.069

0.83 (0.61–1.11)

0.210

0.69 (0.52–0.93)

0.014

  1. CKD chronic kidney disease, BP blood pressure, aOR adjusted odds ratio, CI confidence interval, HbA1c Hemoglobin A1c, ACEi Angiotensin converting enzyme inhibitor, ARB angiotensin receptor blocker, NSAID nonsteroidal anti-inflammatory drug
  2. Differences in the unadjusted prevalence of quality indicators across reimbursement types were assessed using unadjusted logistic regression
  3. Model 1 – adjusted for patient characteristics: age, sex, race, comorbidities, total number of chronic conditions, and patient payor type
  4. Model 2 – adjusted for Model 1 + physician/practice characteristics: United States Census Region, metropolitan statistical area, solo practice, physician specialty, physician compensation, practice ownership, and physician employment status
  5. aHypertension and nonmissing blood pressure reading
  6. bDiabetes and nonmissing HbA1c data