• Chris Miller-Rosales, Amanda L Brewster, Stephen M Shortell, and Hector P Rodriguez.
• University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA 94720-7360. Email: hrod@berkeley.edu.
• Am J Manag Care. 2023 Apr 1; 29 (4): 196202196-202.

ObjectivesPhysician practices are increasingly owned by health systems, which may support or hinder adoption of innovative care processes for adults with chronic conditions. We examined health system- and physician practice-level capabilities associated with adoption of (1) patient engagement strategies and (2) chronic care management processes for adult patients with diabetes and/or cardiovascular disease.Study DesignWe analyzed data collected from the National Survey of Healthcare Organizations and Systems, a nationally representative survey of physician practices (n = 796) and health systems (n = 247) (2017-2018).MethodsMultivariable multilevel linear regression models estimated system- and practice-level characteristics associated with practice adoption of patient engagement strategies and chronic care management processes.ResultsHealth systems with processes to assess clinical evidence (β = 6.54 points on a 0-100 scale; P = .004) and with more advanced health information technology (HIT) functionality (β = 2.77 points per SD increase on a 0-100 scale; P = .03) adopted more practice-level chronic care management processes, but not patient engagement strategies, compared with systems lacking these capabilities. Physician practices with cultures oriented to innovation, more advanced HIT functionality, and with a process to assess clinical evidence adopted more patient engagement strategies and chronic care management processes.ConclusionsHealth systems may be better able to support the adoption of practice-level chronic care management processes, which have a strong evidence base for implementation, compared with patient engagement strategies, which have less evidence to guide effective implementation. Health systems have an opportunity to advance patient-centered care by expanding practice-level HIT functionality and developing processes to appraise clinical evidence for practices.

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