Newtown, CT – November 27, 2015
For those who have toiled in the darkness that envelops health care pricing information, there is much to be thankful for this year. The same cannot be said about information on physician quality – Our third annual report card on physician quality transparency shows that not much has changed. A few States have improved, including California, which is great, but those who had an F last year, got an F this year. And that means over 200 million Americans do not have ready access to information on the quality of care delivered by their physicians. Apparently, few care about this sorry state of affairs, or maybe there’s wishful thinking that the continued growth of health systems through physician practice acquisition will magically solve the problem by providing consumers with some general aura of quality lustered by a locally recognized brand. Sadly, that will only convert darkness to deception, because from what we see the variation of physician quality that exists within a health system is just as bad as the variation that exists outside. The truth is that there’s no reason whatsoever why consumers shouldn’t have as much right to physician quality information as they have to prices charged by those same physicians. And yet, while the limelight is shining on price, mum’s the word on quality. That’s about to change.
What this means to you – In a companion Issue Brief to the Report Card, we outline a method that we have been working on and refining for a decade. Built on early findings in the development of the PROMETHEUS Payment model that there were significant costs and variability associated with potentially avoidable complications, we have worked through a means to reliably calculate risk-standardized rates of those complications (the acronym is RSPR), at the physician and facility levels, for specific episodes of care. Practically speaking, this means a consumer wanting to know how well a physician will manage her child’s asthma will be able to see that provider’s RSPR as above average, average, or below average. And ditto for pretty much any other common condition and procedure. Of course, you need a lot of data to calculate these rates and states with APCDs should be able to handle this easily, if they have the political will to do so. While this measure is not the end all – be all, it’s a great start. For fifteen years we have patiently asked physicians to volunteer information on the clinical quality they deliver through our Bridges To Excellence programs, and while there has been progress in reporting, overall participation is very low, and there doesn’t seem to be any strong desire to change that. So our hope is that as we publish rates of avoidable complications, physicians will start augmenting those measures with others that come from their medical records and patient surveys. But let’s be clear, we’re no longer willing to simply hope for those additional data and metrics to magically materialize. We will provide consumers with the information they have the right to have, and when we pierce that darkness there’s a good chance more light will follow. And for that, we shall all be thankful.