Massachusetts Health Quality Partners issues primary care physician quality report

Massachusetts Health Quality Partners works with physicians and health plans to provide periodic public reporting of physician quality indicators. The latest report is available on their website this week.

Here’s the press release:

Boston, Mass. April 2, 2008 – A report released today by Massachusetts Health Quality Partners (MHQP) finds that, overall, primary care physicians in Massachusetts continue to excel in providing preventive care and in helping patients manage chronic conditions, but that there are still significant opportunities to improve health outcomes and control unnecessary health care spending.

MHQP compiled quality data for 150 medical groups across the state for their fourth annual Quality Insights: Clinical Quality in Primary Care report. The results can be viewed at mhqp.org, where a simple web tool allows people to look up clinical quality measures that are important to them and compare the ratings of medical groups by name or location.
Massachusetts physicians perform better than the national 50th percentile on 24 of 25 quality-of-care measures reported by MHQP this year, and above the national 90th percentile on 12 of 25 measures. For instance, on measures for managing chronic diseases like diabetes and adult asthma, Massachusetts physicians performed well above the 50th percentile national benchmark but below the 90th percentile.

“Massachusetts physicians continue to earn high marks for key quality measures, but we also found sizable variations among medical groups throughout the state as well as gaps between quality performance for some chronic conditions and measurable improvements in patients’ health outcomes,” said Barbra Rabson, executive director of MHQP. “These gaps represent important opportunities for doctors and patients to collaborate in improving quality and controlling costs.”

Clinical outcome data included for the first time
This year’s MHQP report includes, for the first time, statewide “outcome” measures that indicate how well certain risk factors related to patients’ chronic conditions are being managed. For instance, 47 percent of diabetic patients in this report are keeping their LDL (bad) cholesterol levels below the recommended threshold of 100, and 66 percent are meeting the standard for blood pressure control. In all of the six outcome measures reported, statewide performance was above the NCQA national 50th percentile, but only one was at the 90th percentile – avoiding poor blood sugar levels (HbA1c above 9) by patients with diabetes.[Editorial Note: See attached checklist for how doctors and patients with diabetes can work together to control high blood pressure.]

“MHQP’s outcome measures highlight how important it is for physicians and patients to work in partnership on health improvement,” said Marilyn Schlein Kramer, Executive Director of the Partnership for Healthcare Excellence. “Physicians can provide diagnoses, test results, prescriptions and recommendations that will help patients control their chronic conditions; patients can then engage in addressing the often difficult clinical and lifestyle changes that will improve their own health.”

Report addresses costly overuse of care
The MHQP report includes data on the appropriate use of antibiotics for the treatment of childhood colds and other upper respiratory infections and imaging studies such as X-rays, CT scans and MRIs for assessing acute low back pain in adults. Health experts agree that overuse or misuse of tests, procedures and medications can contribute to rising health care costs without improving quality of care, and, in some cases, at the expense of quality.

MHQP found that Massachusetts physicians avoid the inappropriate prescribing of antibiotics 90 percent of the time, which means that one child in ten who is taken to the doctor for a cold, cough or upper respiratory infection receives an antibiotic prescription that is unnecessary.

The NCQA standard for adults with acute low back pain for most patients is to follow a course of general medical care and self treatment for at least four weeks before doctors use imaging tests as a means of further diagnosis. Massachusetts physicians met this standard 80 percent of the time, which is just below the national 90th percentile benchmark. Results among medical groups varied by over 30 percentage points, from a low of 64 percent of patients avoiding potentially inappropriate care to a high of 95 percent.

“These results suggest that many Massachusetts physicians are skilled at helping patients understand when certain drugs and procedures are not necessary and that reducing variations among medical groups will be good for both quality and cost,” said Rabson. “An important message for the entire community is that high-quality care does not always mean more care.”

Physicians use MHQP reports for improvement
Even in areas where Massachusetts rates are above the national 90th percentile benchmark, there is significant variation among groups. For instance, the state rate for cholesterol screening for diabetics is 89 percent, but rates among medical groups range from 61 to 98 percent; and the state rate for colorectal cancer screening is 69 percent, but medical group rates range from 40 percent to 93 percent, a variation of more than 50 percentage points.

“Accurate reporting lays the foundation for quality improvement.” said B. Dale Magee, M.D., M.S., president of the Massachusetts Medical Society. “MHQP encourages continuous quality improvement with trusted information and a spirit of collaboration. Physicians, along with other stakeholders, have a voice in the measurement process, which sets MHQP’s reporting apart from other programs.”

MHQP’s results are based on widely accepted standards developed by the National Committee for Quality Assurance to assess the quality of care delivered to members of health insurance plans nationally. MHQP analyzes and reports on performance data for patients covered by Blue Cross Blue Shield of Massachusetts, Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New England, and Tufts Health Plan. [Editor’s note: You can use the zip code function at mhqp.org to look up medical groups in your area.]

About Massachusetts Health Quality Partners
Massachusetts Health Quality Partners is an independent, not-for-profit organization established in 1995 by a group of Massachusetts health care leaders who identified the importance of using valid, comparable quality measures as a way to drive improvement. Its membership reflects a broad-based coalition of physicians, hospitals, health plans, purchasers, consumers, government agencies and academics working together to promote improvement in the quality of health care services in Massachusetts. MHQP provides reliable information to help physicians improve the quality of care they provide their patients, and help consumers take an active role in making informed decisions about their health care.

April 4, 2008

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