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Publicly-reported data leads to quality

Reported quality measures led physician groups to improve performance

A recent study published in Health Affairs showed evidence that when a physician group’s quality measures are publicly reported, they are more motivated to improve upon their overall care quality.

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Researchers from the Medical College of Wisconsin analyzed 14 publicly-reported quality of ambulatory care measures from 2004 to 2009 for the Wisconsin Collaborative for Healthcare Quality, a voluntary consortium of physician groups. They found that the physician groups improved their performance during the study period on many different measures, including cholesterol control and breast cancer screening.

In addition, study author Geoffrey C. Lamb, a professor of internal medicine and director of the Quality Improvement and Patient Safety Pathway at the Medical College of Wisconsin in Milwaukee, said he and his fellow researchers conducted a survey of the collaborative’s members and analyzed Medicare billing data to independently compare members’ performance to that of other providers in Wisconsin and the rest of the United States. Physician groups reported on the survey that publicly-reported performance data motivated them to act on some, but not all, of the quality measures.

According to Lamb, the project was designed as a retrospective study since the authors did not have a randomized control trial. The researchers used the collected data, including resources from the Dartmouth Atlas Project through the Dartmouth Institute for Health Policy and Clinical Practice, to study the 20 physician groups participating in the collaborative. Each group contained between eight and 100 affiliated clinics, both primary care and multispecialty – 582 affiliated clinics in all, said Lamb.

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“In essence, the study was done to get a sense of whether the collaborative was doing any good. There were legitimate questions around if there was true value to any of this. Obviously, since it wasn’t a controlled trial, we had to come up with other measures,” said Lamb. “Our findings show that voluntary reporting of quality measures helps drive improvement for participants, which should lead to better healthcare for our patients.”

In addition to improved performance with cholesterol control and breast cancer screening, the most significant improvement was seen in measures related to diabetes treatment in which performance improved by double digits in three out of six measures and by 2 percent to 9 percent in the other three measures, said Lamb.

“I think there’s real merit to publicly sharing outcomes, and I think that it’s informative to the public at large, but more importantly it’s about putting the dirty laundry out there. They can say, ‘hey, we need to get better on this,’ and can put more energy into it,” said Lamb.

Lamb added that with better patient outcomes and more consistent measures comes fewer costs, which is always on the minds of physician groups.

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