Physician Quality Information: Where It Is and Is Not

Submitted by on Friday, December 19, 2014 - 05:44

Let's say you have a medical problem and are trying to figure out which physician will do a great job managing it. Well, in most states, you're SOL – Our second annual report on the availability of information on the quality of physician care shows that unless you live in a selected few states, you're down to friends and family to get the scoop on competent physicians. The report highlights a few important points. First, providing the general public with information on the quality of physician care is possible. Several states have done and continue to do a good job at highlighting the differences in physician quality. Second, many of those states happen to be states in which the Robert Wood Johnson Foundation's Aligning Forces program has been in effect for several years. Third, the focus is still very much about PCPs, with very little information on specialists. The upshot is that most Americans should have easy access to information on the quality of primary care, but the vast majority don't and should lay the blame squarely where it belongs: on state and federal governments.

What this means to you – Most of the large employers have deployed quality and price transparency tools, but they should look carefully at the origin of these data sets. That's because our report also reveals that very few measures on hospital quality, if any, differentiate one hospital's performance from another. Further, the number of measures on the quality of specialty care is either nil or so low that the measures don't allow for any differentiation either. At a time when health plan members are asked to bear an ever-increasing share of total costs of care, how are they possibly expected to make value-based decisions without any actionable information on the quality of care? Health plans will respond that the information on their web site is actionable, but surveys continue to point out that most plan members don't trust that information, and other studies also point to the inherent deficiencies of metrics on many physicians in plan directories due to small sample sizes. But before you give up, note the states that have gotten an A on our report card. They have found a way to get the information that matters and to publish it. Yes there's more work to be done, but the solid foundation is in place. We can continue to be complacent about this sad state of affairs, or we can decide to take concrete action. We choose the latter and will be devoting a lot of our resources in 2015 to creating and disseminating measures on hospital and physician quality that are meaningful to consumers and actually differentiate provider performance. State and federal agencies that care about the residents of this country can follow our lead and that of the As, or choose to stay in the hall of shame.