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VOLUME 53 | NUMBER 3 | JUNE 2018


A TwoStep Method to Identify Positive Deviant Physician Organizations of Accountable Care Organizations with Robust Performance Management Systems

Objective: To identify positive deviant (PD) physician organizations of Accountable Care Organizations (ACOs) with robust performance management systems (PMSYS).

Data Source: Third National Survey of Physician Organizations (NSPO3, n = 1,398).

Study Design: Organizational and external factors from NSPO3 were analyzed.

Data Collection/Extraction Methods: Linear regression estimated the association of internal and contextual factors on PMSYS. Two cutpoints (75th/90th percentiles) identified PDs with the largest residuals and highest PMSYS scores.

Principal Findings: A total of 65 and 41 PDs were identified using 75th and 90th percentiles cutpoints, respectively. The 90th percentile more strongly differentiated PDs from nonPDs. Having a high proportion of vulnerable patients appears to constrain PMSYS development.

Conclusions: Our PD identification method increases the likelihood that PD organizations selected for indepth inquiry are highperforming organizations that exceed expectations.

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