|Massachusetts Health Quality Partners Issues 2009 Report On Quality Of Care
Massachusetts Health Quality Partners (MHQP) released
the organization’s fifth annual Quality Insights: Clinical
Quality in Primary Care report, comparing the performance of 150
medical groups across the state.
On MHQP’s Web site, consumers can compare how well
medical groups perform in meeting national standards for providing
preventive care, helping patients manage chronic conditions such as
diabetes, and avoiding the overuse of certain medications and tests.
MHQP was recently chosen by the Massachusetts Health
Care Quality and Cost Council to develop a three-year plan for the
public reporting of comparative healthcare quality and cost information
"We have seen statewide improvements in physician
performance over the five years that MHQP has been measuring and
publicly releasing comparative performance reports," said Barbra
Rabson, executive director of MHQP. "We know that physician leaders
take these reports seriously and use them to target internal
improvement efforts. We are greatly heartened by the improvements
statewide, but there is still far too much variation in performance
among medical groups across the state."
For the eight clinical measures that can be trended from
2003 to 2007, MHQP results show that statewide performance has improved
for all eight, with chlamydia screening, teen well-child visits, and
blood sugar testing for people with diabetes showing the greatest
improvements. This year’s report found that, overall,
Massachusetts physicians performed better than the national average on
28 of 30 quality-of-care measures reported by MHQP, and above the
national 90th percentile on 14 of 30 measures.
The 72 medical practices that comprise the Pediatric
Physicians’ Organization at Children’s Hospital (PPOC) are
one example of how physician organizations have used MHQP data to focus
on areas of greatest need and identify variation and best practices
within an organization, according to Dr. Greg Young, who is
PPOC’s president and CEO.
"It’s very important to the physicians that the
Quality Insights reports are being managed through a process that
involves all the stakeholders," Young explained, "MHQP is seen as
impartial, with noagenda other than improving quality, which helps
increase physicians’ acceptance and their engagement in
At Young’s practice, Longwood Pediatrics, a recent
focus has been on improving follow-up care for children who are
prescribed medications for Attention Deficit Hyperactivity Disorder
"The MHQP data points out that there is a real gap
between where we are and where we want to be," Young said. "Once the
group agreed that the measure was valid and important to the care of
patients with ADHD, we collaborated with the full-time licensed
clinical social worker in our office to work with kids receiving
medications – and their families – and we changed several
of our standard office practices to ensure the scheduling of follow-up
Progress Measured On Managing Chronic Disease Risk Factors
This year’s MHQP report includes seven statewide
measures that indicate how well certain clinical factors related to
patients’ chronic conditions are being managed. Performance on
six of these outcome measures improved over the past year, including
these significant increases:
- The rate for cardiovascular patients who had their cholesterol levels under control rose from 61 percent to 68 percent.
- The rate at which patients with diabetes controlled their blood sugar (HbA1c) rose from 42 percent to 49 percent.
It is important to continue to improve on these outcome
measures because when patients and physicians manage chronic diseases
effectively, patients stay healthier, and these conditions become less
expensive to manage.
Large Variations in Performance Indicate Opportunities for Improvement
Despite the overall high level of clinical quality among
primary care physicians, MHQP has consistently found that there are
large differences in performance among medical groups in all parts of
the state. For example, the statewide rate for colorectal cancer
screening is 69 percent, but the variation in this measure among
medical groups ranges from 42 percent to 89 percent.
"The highest-performing physician groups have achieved
standards of care that should be available to every patient of every
physician in Massachusetts," said Rabson. "That’s why we
encourage medical groups to use our reports to focus on the best
opportunities for improvement and we encourage consumers to use the
tools on our Web site to compare the performance of groups in areas of
clinical quality that are most important to them."
The Quality Insights report is based on widely accepted
standards developed by the National Committee for Quality Assurance
(NCQA) to assess the quality of care delivered to members of health
insurance plans nationally, and uses performance data for commercially
insured patients covered by Blue Cross Blue Shield of Massachusetts,
Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New
England, and Tufts Health Plan.
Address: Massachusetts Health Quality Partners, 100 Talcott Ave., Watertown, MA 02472; (617) 402-5020, www.mhqp.org.