How do managed care organizations and large physician groups implement and use health information technologies (HIT)? Investigators at the University of California, San Francisco will: 1) develop a conceptual and theoretical framework for understanding HIT use; 2) obtain and analyze information on HIT, especially clinical information; and 3) analyze effects of existing HIT developments on purchaser, regulator, and legislator policies for quality reporting requirements and payment models. They will also explore the effects of HIT on contractual and ownership relationships among managed care organizations. Methods will include interviews of managers in 30 physician groups and 6 HMOs, and managers in the groups’ parent firms, if applicable. Both capitated groups and groups which accept few capitated contracts will be included. They will also conduct interviews of HCFA, industry association staff/ public managers in selected states, and NCQA staff about the relative importance of existing HIT as obstacles to strengthening performance reporting requirements and introducing risk-adjustment capitation rates. The objective of the project is to help policy makers, regulators, managers and researchers understand the economic logic of HIT use in managed care organizations and physician groups, and policies that could hasten the pace of HIT change. This study will complement another HCFO grant being investigated by researchers at the University of Minnesota on health information technologies.