Fed Gov't and California Cooperative Partner to Promote Better Physician Performance

The California Cooperative Healthcare Reporting Initiative (CCHRI), a statewide collaborative representing physician groups, health plans, and health care purchasers, announced entering a subcontract agreement with the Delmarva Foundation for Medical Care, one of the Centers for Medicare and Medicaid Services’ (CMS’) quality improvement organizations, to be one of six sites around the country, as part of the Better Quality Information to Improve Care for Medicare Beneficiaries (BQI) Project. The project is aimed at compiling and communicating information to Medicare beneficiaries on doctors’ performance.

“The BQI project will give Medicare beneficiaries a broad overview of provider performance resulting in better choices in meeting their health care needs,” said CMS Acting Administrator Leslie V. Norwalk, Esq.

“This collaboration is truly groundbreaking — California health plans, physician groups, and purchasers are working closely with doctors to make sure we can give both consumers and their physicians valid information. The California project is by far the largest in the nation, and will generate performance information on over 25,000 physicians,” said Peter Lee, CEO of the Pacific Business Group on Health, noting, “California is demonstrating a model that can be used throughout the nation.”

The federal government has made it a priority to promote better physician performance and increase consumer engagement in decision making regarding their health care choices. These priorities support the national trend to make healthcare quality and cost information available in a meaningful way for both physicians and consumers. A unique aspect of the BQI pilots is that, for the first time, they will combine Medicare data with data from commercial health plans in each pilot state, including three leading partner health plans in California – Blue Shield of California, Blue Cross and Pacificare/United Health Care. Pooling these data means that there will be a large enough sample of patients with which to measure the performance of most primary care physicians, along with many specialists, in the state.

“Doctors want to know how they are doing and where they can make improvements. This effort will bring about meaningful ways to measure doctors’ performance and report results that ultimately bring about change,” said Ron Bangasser, MD, Past-President of the California Medical Association and co-Chair of the CCHRI Transparency Initiative Steering Committee.

CCHRI has selected Thomson Medstat as the technical partner to manage the data aggregation process and will be working with Lumetra, California’s Quality Improvement Organization, to develop tools and programs that will assist physicians in using the information to drive improvements in their medical practices.

“Over the past several years Lumetra has worked closely with California physicians to support their efforts to improve their practices. We know that reporting performance alone will not drive change and are excited about being part of this effort to combine performance measurement with the provision of programs and tools that will drive improvement,” said Jo Ellen Ross, President and CEO of Lumetra.

Gifford Boyce-Smith, MD, Senior Medical Director for Quality of the health plan partner from previous PBGH physician performance measurement initiatives, praised the project, saying “Blue Shield of California is committed to providing doctors and consumers meaningful information that strengthens decision making and improves our health care system. Working in collaboration and pooling data will enable us to assess the performance of more physicians and on a broader scope to more comprehensively assess what they do in everyday practice.”

CCHRI expects to begin collecting and aggregating data from CMS and the three largest PPOs in California within the next month. Performance results reports will be available to physicians by mid year.