Physicians and Employers Working Together on Performance Measurement
The Maine Health Management Coalition (MHMC) is taking the first steps in attempting to measure performance at the medical practice level through its project called, Informing Patients and Rewarding Providers (IPRP). MHMC is a coalition of 14 public and private employers, 9 hospitals, 5 physician groups and 4 healthplans who are collaborating on a mission to measure and improve the value of healthcare in Maine. The Informing Patients and Rewarding Providers project is lead by a Steering Committee of 8 physicians, 5 employers and 3 healthplan Medical Directors.
The IPRP project has surveyed all primary care practices in Maine with more than 2 physicians to gather information on the systems in place to manage chronic disease. The results have been reported back to the participating practices and a list of participating practices will be posted on the Coalition's website for employees. This year (2003) a revised survey will be administered that will attempt to quantify what each practice is doing.
The group has also retained the Maine Health Information Center to use the coalition claims database on its 275,000 employees to measure compliance of practices in Maine on three measures drawn from well-established guidelines using the HEDIS methodology developed by the National Council on Quality Assurance (NCQA). Statistically valid results have been produced on 47 practices and these results will be mailed to those practices next week. A consumer version of the results will be made available to employees and family members in March. The group is planning to collect outcomes data directly from practices in 2003. The three measurements looked at in 2002 included HbA1C's and LDL-C's for diabetes care and the use of controlled meds for patients with asthma.
The employers in the Coalition realize that the current mechanisms for paying for healthcare do not reward investments in quality improvement. Therefore, a key part of this initiative is to create financial and non-financial incentives that will create a business case for quality. The members have created a $125,000 fund to recognize those practices that have invested in systems that are producing better results and to provide some assistance to those who want to improve systems. More importantly, MHMC members are working with their healthplans to incorporate stronger performance incentives for a standardized set of metrics into the reimbursement model.
While the Maine Medical Association does not endorse this effort, MHMC has kept the Association well informed of this project from its inception and all of the physicians on the steering committee are MMA members. MHMC has also retained Jan Wnek, M.D. as a clinical advisor to the project. Anyone wishing additional information on the project can contact Dr. Wnek at firstname.lastname@example.org.
Presentations on the project will be part of the Association's Annual Physician Survival Programs being held in the Spring. The programs this year will be held in Bangor on May 28th and in South Portland on June 25th. Registration materials for the all-day programs will be mailed with the March and April issues of Maine Medicine. [return to top]