No one can predict whether President Obama and the Congress will be able to forge an agreement on national health care reform, but there is one thing everyone seems to agree on: we need to receive far more value from our health care system – in other words, more quality and better outcomes for each dollar spent.
As readers of this blog know all too well, efforts to manage costs and improve quality have been ongoing for decades, but they are too often stymied by the way U.S. health care is organized, financed and segmented. There's an emerging consensus, however, that health-care stakeholders need reliable, transparent quality and cost data in order to close the value gap. If it can't be measured and reported, it can't be improved.
For the past five years, Massachusetts Health Quality Partners (MHQP) has been measuring and publicly releasing quality data comparing how well primary care 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. Our latest Quality Insights report on the performance of 150 medical groups from across the state has just been posted here.
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. What's more, statewide performance among medical groups has improved among all eight of the clinical measures that MHQP has been able to track for the five-year period.
While these results are heartening, there is still far too much variation in performance among medical groups across the state. The highest-performing physician groups have achieved standards of care that should be available to every patient of every physician in Massachusetts. That's why we encourage physician group leaders to use our Quality Insights reports to target internal improvement efforts – and many do just that.
As Dr. Greg Young, who is a member of MHQP's Physician Council, has pointed out, “MHQP is an independent organization with no agenda other than improving quality, and we involve all the stakeholders in deciding what should be reported and how. This helps increase physicians' acceptance of the data and their engagement in improvement initiatives.”
For example, Longwood Pediatrics, where Dr. Young practices, has used MHQP reports on follow-up care for children who are prescribed ADHD medications to target improvement efforts. As he describes it: “The MHQP data points out that there is a real gap between where we are and where we want to be. 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 visits.”
It seems to me that the lesson here is clear: When it comes to measuring, reporting and using health care data, collaboration breeds trust, and trust is essential for any kind of improvement efforts to take hold. It's not quick or simple, but it's the surest route to enhancing value in our health care system.
Executive Director, Massachusetts Health Quality Partners
This program aired on April 2, 2009. The audio for this program is not available.