This is a guest post by Barbra Rabson, Executive Director of Massachusetts Health Quality Partners (MHQP), on the occasion of the release of MHQP’s latest clinical quality report.
As Massachusetts policymakers debate what can be done to tame rising health care costs, let’s not forget that the overriding goal must be to improve the health and well-being of our state’s residents while spending less of consumer, employer and taxpayer money. In other words, we need better outcomes and better value for our health care dollars. Getting there will not be easy, but there are two principles everyone should be able to rally around: 1) the health care system needs a greater emphasis on primary care, and 2) it needs much more patient engagement.
There is ample evidence that expanded access to high-quality primary care is beneficial, and that it leads to improved prevention and control of chronic illness, better coordination of care, and a reduction in unnecessary emergency room visits and hospital admissions. As for patient engagement, a recent survey by the Commonwealth Fund confirmed what other research has consistently found – that patients who take an active role in their own care, “from self-managing a health condition to actively participating in treatment decisions,” experience higher quality of care and fewer medical errors.
Thanks to an ongoing collaborative effort among physicians, health plans, purchasers, and consumers, Massachusetts has powerful tools available to support the enhancement of primary care and patient engagement. For more than a decade, Massachusetts Health Quality Partners (MHQP) has been measuring, analyzing, and reporting on the performance of the state’s primary care physicians in two critical areas – clinical quality and the patient experience. MHQP’s latest report, which summarizes multiple dimensions of clinical quality for more than 4,000 primary care physicians at 150 of the state’s medical groups, was released this week. It is available online, at mhqp.org, in a format that allows for easy comparison and analysis.
The measurement and transparent reporting of clinical quality information equips patients and consumers to be much more actively involved in decisions about how to get the right care, in the right place, at the right time. In addition, the reporting of reliable, evidence-based data can help to drive improvements in medical practice. There have been numerous examples where physician groups have used the information in MHQP clinical quality reports to redesign care for patients with chronic conditions including diabetes and asthma, or to reduce costly, inappropriate care such as the overuse of antibiotics or the misuse of imaging for lower back pain. Statewide, primary care is improving, and MHQP is able to capture these trends. Although there is still too much variation among physician groups on some aspects of clinical quality, every measure that MHQP has tracked over the last eight years has shown improvement.
Regardless of what happens on Beacon Hill, the next wave of Massachusetts health reform is already upon us. In recent years, we have seen a growing movement toward changing the way physicians and hospitals are paid and the way medical care is organized and provided. If done right, these changes will help to improve the coordination, effectiveness, and efficiency of care, especially for people with chronic conditions and intensive medical needs. But getting the next phase of reform right means that the likely solutions to rising costs – payment reform and new “systems of care” like medical homes and accountable care organizations – will have to strongly emphasize high quality primary care, patient engagement, and an excellent patient experience.
With reliable, trusted data and actionable information on what works, who produces what results, and how performance can be improved, consumers, patients, and providers can all contribute to improving our health care system.