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State Report Card on Transparency of Physician Quality Information

HCI3 Improving Incentives Report - December 2013

Authors: Francois de Brantes, MS, MBA; Elizabeth Bailey, MPH; Jessica DiLorenzo, MA; Michael Moses, MS;

Introduction

In its seminal publications on the Quality of Health Care in America, the Institute of Medicine called for the measurement and reporting of physician quality. That was in 1999 and 2000. Since then much work has been done in the private and public sectors to establish measures for various conditions and procedures, using the American Medical Association's Physician Consortium for Performance Improvement and the National Quality Forum's processes for measure development and endorsement. Many payers, including Medicare, require various forms of quality of care reporting, and use these measures to "rate" physicians or trigger supplemental payments.

And yet, finding information on the quality of physicians remains elusive for most consumers. While Medicare has a public web site that contains information on physicians, it is completely void of any data on the quality of care delivered. That's all the more surprising since physicians have been reporting a basket of quality measures to Medicare for several years.

There are commercial websites that provide some information on the quality of physician care, but there's often a fee to pay for the full report, and the objectivity of the data on those sites has been questioned by many researchers.

To respond in part to this paucity of publicly available, objective and trustworthy information, the Robert Wood Johnson Foundation launched an ambitious effort several years ago whereby certain communities would agree on a set of quality measures that would be systematically collected, reported and monitored. The Aligning Forces For Quality (AF4Q) effort has, to-date, remained one of the few bright spots across the U.S. in providing transparent quality information to consumers. Similarly, large employers and some health plans embarked on a comprehensive effort to recognize and reward clinicians and physician practices that could demonstrate they were delivering good quality care, especially for patients with chronic conditions. Bridges To Excellence (BTE) remains the country's largest and broadest effort to highlight and reward clinicians for quality care.

The data collected and displayed by AF4Q and BTE remain the only widespread sources of publically available information on the quality of clinicians. And this State by State Scorecard highlights the extent to which there are still huge gaps in these data. Similarly to the State Scorecard on Price Transparency that we copublished with Catalyst for Payment Reform earlier this year, this Scorecard shows that the vast majority of States in the US get a failing grade in Quality Transparency.

Close to 15 years after the IOM's Crossing The Quality Chasm, we have no idea, for the most part, on the quality of care delivered by the majority of clinicians in the U.S. That's not just shameful, it puts patients at risk every day, and we hope that highlighting States that have made a conscious effort to provide these data to consumers will encourage others to embark on similar efforts...

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IssueBrief-Dec2013.pdf1.7 MB