Report Finds 40% Differences In Mass. Primary Docs' Quality

Attention, primary care patients, which means just about all of us. A new study from Massachusetts Health Quality Partners finds that the state remains a great place to be a patient, and it's getting even better. But there are some major disparities among medical groups in performance as measured by MHQP's quality indicators, from testing for strep throat before prescribing antibiotics to using scans to diagnose lower back pain.

The Massachusetts quality numbers come out just as national attention to the need for more careful and effective care has been rising. On Wednesday, nine medical specialty groups released recommendations that 45 common tests be performed less frequently. (See local specialists' useful comments in "Tests You Don't Need" in The Boston Globe.)

Massachusetts Health Quality Partners has been tracking the state's doctors' performance on 24 "process measures" — does the practice adhere to the recommended guidelines? — for eight years now, including asthma management, well-child visits, antidepressant prescriptions, cholesterol control and more. The new data summarize care quality among about 150 medical groups and 4,000 medical staffers. Check out the full report — and possibly your own doctor's performance — here. Some press release excerpts, skipping the good news about our generally high quality and getting right to the gaps:

But not all health care in Massachusetts is the same. There is high variation in how pediatricians across the state perform. For the same strep throat measure, some pediatricians gave the recommended care 100 percent of the time, while others did so only 60 percent of the time. A variation of 40 percentage points shows the differences in care a child could receive depending on where they go for care.

“People in Massachusetts are facing decisions about choosing where they go for care within tiered and limited networks,” said Barbra Rabson, executive director of MHQP. “Reliable quality information is important to help individuals and families make more confident decisions about where to get their care.”

And:

Quality varies among medical groups across Massachusetts.
Across all regions of the state, it matters where a patient goes to get care. While MHQP’s report show’s very little variation in care across the six Massachusetts regions (Western MA, Central MA, Metro West, Greater Boston, Northeastern MA and Southeastern MA), the care among medical groups within a given region can vary greatly.

Most measures show wide variation among medical groups, underscoring there is still room for continued improvement.
Of the 24 process measures that MHQP tracks and publicly reports, 12 measures showed variations of 40 percentage points or more between the highest and lowest performing medical groups.
When measuring whether an imaging study was used appropriately to diagnose lower back pain, the state rate was 78 percent. However there was a variation of 40 percentage points between the lowest (51 percent) and the highest (91 percent) rates.
The percent of adolescents getting well care visits varied by 50 percentage points across the state. MHQP’s data can show which medical groups are providing the most consistent care.

Wondering how your own doctor measures up?

On www.mhqp.org, patients can review information about the performance of their local medical groups on a range of medical conditions including diabetes, cardiovascular disease, asthma care, pediatric care, and antidepressant medication management among others. MHQP’s Quality Insights in Primary Care report provides detailed information about the performance of medical groups across the state.

Readers, if you try navigating the data, please let us know how it goes.