Business Insurance Print Version
January 3, 2014
A new report that gives the majority of states a failing grade for providing quality information on doctors could fuel the fear and confusion felt by many employees when it comes to seeking out medical options at a time their employers are asking them to be more conscientious consumers of healthcare, experts say.
The "State Report Card on Physician Quality Information," published Dec. 10 by the Newtown, CT-based Health Care Incentives Improvement Institute Inc., gave only two states?Minnesota and Washington?an A, while California barely passed with a grade of C. Every other state performed worse.
"The quest for quality information has been like the search for the Holy Grail," said Marianne Fazen, president and CEO of the Dallas-based Texas Business Group on Health, which is launching its own action-focused think tank in January in an attempt to drive improvements in provider quality in that state.
"Employers have been looking for credible information for decades," she said, but instead have been confronted with "a plethora" of different metrics developed by various organizations.
"We've had quality assessments coming from the Leapfrog Group, the National Committee on Quality Assurance, the Joint Commission, the American Hospital Association, medical specialty societies?but everybody's using a different set of metrics. No employer is going to wade through it all and try to figure out what it all means," she said.
Moreover, "how are they going to help their employees make informed decisions? I think it's time for someone from a company like Apple Corp. to make a tool that's as easy to use as the iPhone to decipher all of this medical quality information," = Fazen said.
But Francois de Brantes, HCI3's executive director, said the objective of the report card is to encourage further transparency efforts by highlighting those states that have done a fairly good job of providing such information to consumers.
"We're 15 years out from the Institute of Medicine's trailblazing report calling for the transformation of a 'fundamentally flawed' healthcare system, and for the most part we still have no idea of the quality of care delivered by the majority of physicians in the U.S.," he said. "That's not just shameful, but it unnecessarily puts patients at risk."
Instead of producing yet another set of metrics to attempt to measure quality, Cyndy Nayer, founder and CEO of the Naples, FL-based Cyndy Nayer's Center of Health Engagement, suggested that "we need to get the thought leaders together and merge the thinking and also take a look at what's coming down the pike" with healthcare reform. "We should be able to put an information pathway together."
In the meantime, "I'm not sure we should be measuring intermediate outcomes," she said.
For its report card, HCI3 graded states on the percentage of physicians and supporting healthcare professionals, such as physician assistants and nurse practitioners, who publicly report quality information; the type of measurement provided, such as outcomes, process and/or patient experience; and the accessibility of this information to consumers. The Robert Wood Johnson Foundation's national directory for comparing healthcare quality served as the starting point for the review, with researchers examining whether that information was current, free to consumers and produced by independent third parties, and it included a range of physicians, including specialists and supporting healthcare professionals.
Donna Marshall, executive director of the Colorado Business Group on Health, which annually publishes a report on Colorado physicians who have attained recognition in the treatment of either diabetes, cardiac or primary care, objected to the low score her state received on HCI3's report card.
"The recent publication by HCI3 suggests that Colorado has no resource that offers information on quality physicians that is timely, readily available, free and published by a credible and objective source," she said. "We are pleased to be a ready resource for our fellow Coloradans who are looking for high-quality physicians."
The report, available online, contains information on 700 of the state's estimated 3,500 primary care physicians, she said.
However, de Brantes explained that while most states?including Colorado?had readily available information on the quality of primary care doctors, such information on specialists or supporting healthcare professionals was "severely lacking." He estimated that only about 20% of medical care is delivered by primary care doctors, with the remainder provided by specialists and supporting healthcare providers.
de Brantes said the two states receiving "A" grades have had strong, consistent measuring and reporting programs in place for many years.
Minnesota, for example, has had statewide transparency initiatives for more than a decade, resulting in 66% of clinicians reporting quality data. In addition, Minnesota HealthScores, an online resource, provides "patient-friendly" quotes quality reports on area clinics, medical groups and hospitals as well as average cost comparisons for common procedures.
In Washington, the Puget Sound Health Alliance compares the performance of doctors in medical groups across several practice areas, including treatment of diabetes, heart disease, asthma, chronic obstructive pulmonary disease and assessment of patient experience. Its database includes quality information on 55% of the medical providers in the state, he noted.
Meanwhile, California, which received a passing grade of C, has publicly available quality information on only 37% of medical providers in the state, according to the HCI3 report.
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