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Home / News & IndustryManaged Care Insight and Analysis
Updated: Sept. 9, 2008
Massachusetts Health Quality Partners Issues 2008 Report On Quality Of Care

Primary care physicians in Massachusetts continue to excel in providing preventive care and in helping patients manage chronic conditions, but there are still significant opportunities to improve health outcomes and control unnecessary healthcare spending, according to a report by the Massachusetts Health Quality Partners (MHQP).

MHQP compiled quality data for 150 medical groups across the state for their fourth annual "Quality Insights: Clinical Quality in Primary Care" report.

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.

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 National Committee for Quality Assurance (NCQA) national 50th percentile, but only one was at the 90th percentile –avoiding poor blood sugar levels (HbA1c above 9) by patients with diabetes.

The MHQP report also 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 healthcare costs without improving quality of care, and, in some cases, at the expense of quality, MHQO said.

MHQP found that Massachusetts physicians avoid the inappropriate prescribing of antibiotics 90 percent of the time, which means that one child in 10 who is taken to the doctor for a cold, cough or upper respiratory infection receives 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.

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.

MHQP’s results are based on widely accepted standards developed by the NCQA 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 Healthcare, Health New England and Tufts Health Plan.

Address: Massachusetts Health Quality Partners, 100 Tyalcott Ave., Watertown, NY 02472; (617) 402-5020,

  This article was taken from:
The Executive Report on Managed Care

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