Experiencing Patient Experience results from MHQP
For the past 14 years, Massachusetts Health Quality Partners (MHQP) has published results of its primary care patient experience survey. The information is useful to the practices themselves as they seek to improve, and to health plans looking to evaluate their networks, improve member service, and pay bonuses to the best practices.This year MHQP added an analysis of free text feedback to its analysis, to give practices more color on the scores.The consumer-facing site, Healthcare Compass lets users view ratings for individual practices and compare up to three at a time. Users can click on the individual categories to learn what each one means, what patients can do, what doctors can do, and where to find additional resources. For example, the "what you can do" tab in the communications section includes suggestions to speak up if you want your doctor to make eye contact and to ask the doctor to repeat back what you just said.I used the site to compare three practices I am familiar with and the results match up well with my perceptions.
There is a lot to like about MHQP's patient experience reporting including:
- It provides validated information on key elements of practices, for both adult and pediatric
- The site is easy to navigate. The information is communicated in plain English and with simple, intuitive graphics. For even more detail, you can click on the Harvey balls (I didn't realize this at first) to get the detail behind the score.
- Providers have responded to the feedback by improving performance in key areas over the years, including communications and care coordination
- The bottom line "willingness to recommend" percentage provides a useful benchmark for comparing practices
- For the first time this year, MHQP issued awards for the highest performing practices for adults and pediatrics and for each domain of care. You have to go to the MHQP site itself to see it, but you can bet the doctors know it's there!
MHQP has built trust with providers and payers by working collaboratively with them and taking their sensitivities into account when publishing the performance data. Here's how public reporting of survey results could expand, subject to the consent of providers and payers and additional funding:
- Provide more prominence to the actual scores for the measures, rather than just a three-level Harvey ball (full, half full, empty) showing relative performance. The current approach obscures the fact that median scores for certain categories are much higher than others. For example, the mean score for pediatric practices on patient-provider communications is 97.3% compared with 50.3% for empowering patient self care. While we're at it, it might also be nice to see the range of scores. Does everyone cluster around 50% for self care or do some practices get into the 70s or 80s?
- Provide reporting at the level of the individual MD for measures where that's relevant, e.g., "how well doctors communicate with their patients" and "how well doctors know their patients," while keeping practice-level reporting for measures such as, "getting timely appointments, care, and information." The challenge here is that it would require a much bigger budget to reach the needed sample size
- Provide a synthesis of the qualitative comments
- Provide ratings of specialists as well as primary care
The pushback will be that there are valid reasons to present the information as it is and that expanding will be cost prohibitive, but on the other hand it would make this reliable and validated information more likely to be used.Congratulations to MHQP for its continued success in shining a light on patient experience and making useful information available to all the stakeholders in the Massachusetts healthcare system.
By healthcare business consultant David E. Williams, president of Health Business Group.