"How Measuring Quality Advances Health Care Reform" by Barbra Rabson

Many supporters of Massachusetts health care reform have voiced their concerns on this blog and elsewhere that unless cost and quality are addressed, the goal of nearly universal coverage will be unachievable. They're right. The problem is, we can't possibly hope to improve quality unless we can measure it, and, for the most part, health care quality measurement is still in its infancy. Thanks to a decade of collaboration among providers, health plans, consumer groups, employers, policymakers and health care experts, however, Massachusetts has a pretty good head start over most of the country.

For several years, Massachusetts Health Quality Partners (MHQP) has published unbiased information on how well 150 medical groups across the state meet national standards for preventive services such as cancer screening and well-child care and for the management of patients with chronic diseases such as diabetes and asthma. These are services that are intended to prevent the onset of more debilitating and expensive conditions, so when they are performed well, they not only improve health but also help control costs.

Our 2007 report finds that, overall, primary care physicians in Massachusetts score above the national 90th percentile in 12 of 17 key quality measures developed by the National Committee for Quality Assurance. At the same time, there are significant differences among medical groups for some measures and room for statewide improvement in others.

Consumers can use the information on our website to help them choose physicians and medical groups that can best meet their health care needs, and to talk with their doctors about appropriate care, including what they can do to maintain and improve their own health. And, we are especially pleased that medical groups and individual physicians use MHQP's reports to identify opportunities for closing those quality gaps and improving the way they practice. That is the power of performance measurement and feedback.

With ongoing support from many of the same stakeholders that helped forge health care reform, MHQP has been able to publish highly reliable, actionable quality reports and to refine and expand them each year. But we are still dealing with only a narrow slice of health care delivery. It will take continued collaboration – and strong leadership from the state's new Quality and Cost Council – to break through the remaining barriers and create credible processes for measurement and continuous improvement that extend to all aspects of our health care system.

Barbra Rabson, MPH, is executive director of Massachusetts Health Quality Partners.