A Two‐Step 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 ( ACO s) with robust performance management systems ( PMSYS ). Data Source Third National Survey of Physician Organizations ( NSPO 3, n = 1,398). Study Design Organizational and external factors from NSPO 3 were analyzed. Data Collection/Extraction Methods Linear regression estimated the association of internal and contextual factors on PMSYS . Two cutpoints (75th/90th percentiles) identified PD s with the largest residuals and highest PMSYS scores. Principal Findings A total of 65 and 41 PD s were identified using 75th and 90th percentiles cutpoints, respectively. The 90th percentile more strongly differentiated PD s from non‐ PD s. 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 in‐depth inquiry are high‐performing organizations that exceed expectations.