Report on Medical Group Quality-of-Care

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A Web-based report issued today by the Massachusetts Health Quality Partners (MHQP) gives the public easy access to information on how well the state's physicians provide preventive care services such as cancer screening and well-child care, and how well they manage patients with chronic diseases such as diabetes and asthma. Consumers can look up and compare quality information at www.mhqp.org for approximately 150 medical groups with more than 5000 physicians, by entering a physician's name, a medical group's name or a zip code.

MHQP's 2007 "Quality Insights: Clinical Quality in Primary Care" report finds that Massachusetts physicians score at or above the national 90th percentile on 12 of 17 key measures of clinical quality. A geographical breakdown of the data finds that there are medical groups with performance scores near or at 100 percent on some quality measures in each of the state's five regions -- greater Boston, northeast, southeast, central and west. The report, which updates and expands on quality information that was first made public in February 2005, also indicates that there are significant variations in performance among medical groups for some measures and that there are opportunities for statewide improvement in others.

"Our members have long believed that giving consumers and providers access to reliable, useful information on clinical performance will lead to improved quality of care and, over time, to better control of health care costs," said Barbra Rabson, executive director of MHQP. "We are delighted that physicians have embraced our quality report as an important tool in maintaining and continuously improving medical group performance and we are confident that, combined with other sources of information, our simple Web tools will help individuals make better informed decisions about choosing physicians and medical groups."

This year's "Clinical Quality in Primary Care" report compares medical group performance for 17 of the quality measures developed by the National Committee on Quality Assurance (NCQA) to assess the quality of care delivered to members of health plans nationally. The measures selected by MHQP include: appropriate use of depression and asthma medications, breast, cervical and colon cancer screening, chlamydia screening in young women, overall diabetes care, and pediatric care. The measurement results are based on commercially insured managed care patients covered by Blue Cross Blue Shield of Massachusetts, Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New England, and Tufts Health Plan.

"I see at least three important benefits for individuals and families that use MHQP's Web report, especially those who have access to new coverage options under the state's health reform law," said John McDonough, executive director of Health Care for All, Massachusetts' leading consumer health advocacy organization. "It can help people decide which medical groups have strengths that best meet their needs; it can give them a better understanding of how prevention and chronic care can be improved; and it can help them to start a conversation with their clinicians about appropriate care, including what they themselves can do to remain healthy."

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"Physicians embrace quality measurement and reporting to improve care and reduce costs. It's also important to make accurate, meaningful information available to the public," added B. Dale Magee, M.D., M.S., president of the Massachusetts Medical Society. "MHQP's independent voice is critical to encouraging continuous quality improvement based on trusted information. With it, physician groups can target areas where better systems are needed to improve the rates of appropriate preventive screening, well-child visits, and chronic disease management."

In capturing and analyzing clinical performance data between 2002 and 2006, MHQP has been able to note trends in improvement, variations in results, and areas for continued improvement efforts. Across the state, medical groups are doing especially well in treating childhood asthma and in providing cholesterol testing and blood sugar screening to their patients with diabetes. Massachusetts physicians have improved on 6 of the 8 measures MHQP can trend over the last four years, with cholesterol testing and blood sugar screening for patients with diabetes showing the greatest improvement during this time, followed by well-child visits for teens.

While the trends show improvement overall, there is still variation in performance among medical groups and areas to target for continued improvement efforts. Getting teens in for their preventive care visits can pose a challenge -- medical groups range in success from about 40% to nearly 85%. Colorectal cancer screening rates among medical groups range from 40% to 93%.

Massachusetts physicians perform at a rate below the national 50th percentile for adult asthma management. Massachusetts performs above the national 50th percentile on measures related to depression medication, however statewide performance from 2002-2005 remained flat.

As the number of newly insured Massachusetts residents grows steadily under the state's groundbreaking health care law, policymakers and advocates are increasingly focused on quality and cost. Thanks to more than a decade of collaboration among providers, health plans, consumer groups, and employers, led by MHQP, Massachusetts has a head start over most of the country in measuring, reporting on, and improving health care quality.

"The Quality and Cost Council created by the new Massachusetts health care reform law has drafted ambitious improvement goals for the coming year," said MHQP's Rabson, "and we are very pleased that MHQP will be a key data source for two of them -- improving chronic and preventive care and providing consumers with comparative quality information over the Web."

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