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practices), greater clinical (OR, 4.68; 95% CI, 2.28-9.59; P less then .001) and functional (OR, 4.24; 95% CI, 2.00-8.97; P less then .001) integration, and being located in the Northeast (OR for Midwest 0.47; 95% CI, 0.34-0.65; P less then .001; South 0.47; 95% CI, 0.34-0.66; P less then .001; and West 0.64; 95% CI, 0.46-0.91; P = .01) were associated with greater APM participation. Conclusions and Relevance Greater APM participation appears to be supported by integration and system ownership.Importance Prior studies have identif