"Did Aligning Forces for Quality (
AF4Q) Improve Provider Performance Transparency?
Our exploratory analysis uses data from a random digit dial telephone survey undertaken as part of the evaluation of the
AF4Q initiative.
There is substantial variation in the history of public reporting efforts across the 14
AF4Q regions included in this study (Christianson et al.
Specifically, we sought to determine, approximately 6 years after the program's initiation in 2006, whether chronically ill adults in 14
AF4Q communities reported greater improvement in care coordination, patient satisfaction, provider interaction and support, and receipt of recommended care for diabetes than patients in non-AF4Q communities.
(15) Determining how policy makers might best promote and combine these attributes will require additional study, most likely in the form of additional field experiments (and complementary evaluations) modeled on the earlier pilot Patient Partner programs developed as part of the
AF4Q initiative described earlier (Scanlon et al.
In this case, among all
AF4Q alliances, only Maine shows a significant increase in perceived leadership among all respondents combined.
We assessed differences between respondents and nonrespondents with regard to practice size, specialty mix, region of the country, and whether the practice was located in an
AF4Q community.
Respondents from the 14
AF4Q communities totaled 1,201 practices.
Substantial variation also exists in the differences between the approaches across the
AF4Q communities.
The overall response rate for the survey was 27 percent using the American Association of Public Opinion Research method of response rate calculation (found at http://www.aapor.org/ForResearchers/4362.htm) or 48 percent using the Council of American Survey Research Organizations method, with 7,337 respondents in the 14
AF4Q markets completing the survey.
Nevertheless, we specifically compared several estimates from the
AF4Q Consumer Survey against those from the 2008 National Health Interview Survey (NHIS) in terms of respondents' demographic characteristics and prevalence of comparable chronic conditions, because NHIS has achieved a 90 percent response rate and is thus less likely to be subject to non-response bias.
The primary source was a random digit dial telephone survey of chronically ill individuals conducted in 14 Aligning Forces for Quality (
AF4Q) study areas and a national comparison group between June 2007 and August 2008.