Rankings, Ratings and Report Cards

Massachusetts Health Quality Partners (MHQP) has released its annual report on Clinical Quality in Primary Care for 150 medical groups, and it continues to show that the state's physicians consistently exceed the national norm and often lead the country in key clinical areas related to preventive care, managing chronic conditions, and the appropriate use of medications and tests. There is, however, variability in performance among medical groups, and there are still measures where the numbers aren't as high as any of us would like.

At a time when rankings, ratings and report cards seem to be coming at us from all sides, MHQP's reports have gained a good deal of credibility in the physician community, in part because they are developed through a collaborative process that includes physicians, health plans, purchasers and consumers. And, we think MHQP's reports, stack up very well on attributes that are important to physicians.

What's measured is important. MHQP reports are based on national standards for clinical quality that are closely related to patients' health and well-being. And they continue to evolve. For instance, recently added measures focus on outcomes of care and overuse, as well as processes of care.

The methodologies are widely accepted. MHQP uses NCQA's HEDIS data sets, which have been in use for many years and which are also developed through a collaborative, evidence-based process. We're well aware of the limitations of claims-based data and the need to account better for the types of patients a physician treats, the complexity of their conditions, and their willingness and ability to keep appointments and comply with physicians’ recommendations. Used properly, however, the data can help drive the improvements in patient care we all work toward.

The numbers are large. Since MHQP compiles HEDIS data from the state's five major health plans, reports at the physician group level generally include enough patients to make the data credible and meaningful.

The method of reporting is unbiased, not judgmental or punitive. MHQP doesn't have any agenda other than quality improvement, and they work closely with their Physicians Council (which we both sit on) and other stakeholders, including the Massachusetts Medical Society, to make sure their reports are presented in a way that reflects that spirit. 

The reports are useful to patients and physicians. Patients can use MHQP's reports to gain a better understanding of what constitutes high quality care, the role they play in achieving it, and the relative strengths of different medical groups in areas that are important to them. Physician groups across the state have used the data to target improvement opportunities and to benchmark and disseminate best practices.

No one report can reflect all the important aspects of quality of care, but MHQP has developed a trusted and useful approach to help physicians improve the quality of care we give our patients.


Barbara Spivak, MD
Mount Auburn Cambridge IPA

Edward Westrick, MD
Vice President, Medical Management
UMass Memorial Health Care

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