Physicians to see overall level of treatment their patients receive across five major health plans, compare community-wide levels of treatment
To measure and improve the quality of chronic care, today the non-profit Dallas-Fort Worth Business Group on Health (DFWBGH) is distributing reports on diabetes care quality to 1,300 primary care physicians and endocrinologists throughout Dallas and Fort Worth. Produced by the Partnership for Peak Healthcare Performance, a collaborative program launched by the DFWBGH in 2007, the personalized reports show diabetes care quality results calculated from commercial claims data aggregated across five major health plans.
The DFW Diabetes Care Reports are a first step toward preparing the market for public reporting in the future. Within several years, the DFWBGH expects to make regional five-plan quality reports on physicians available to consumers to help them make informed choices about their healthcare. The reports are currently mailed to area doctors who treated 20 or more patients with diabetes in 2007. The data are aggregated across the five participating health plans -- Aetna, Blue Cross Blue Shield of Texas, CIGNA, Humana and UnitedHealthcare -- to provide physicians a more complete picture of the care their patients are receiving.
"You can't manage what you don't measure," said Virginia Nisbet, president of the DFWBGH and director Benefit Design, Brinker International. "These landmark reports call attention to important process and outcomes measures for diabetes care and provide a benchmark against which to monitor future progress in care improvement throughout the Metroplex."
How are area doctors performing?
On the whole, DFW physicians performed well in diabetes care versus physicians nationwide. The observed rate at which DFW physicians performed recommended diabetes-related tests was on average slightly higher than national average testing rates reported by the National Committee on Quality Assurance.*
Building on better than average performance, the PPHP sees opportunities to improve the total system of diabetes care through physician office process improvements, better patient education and self-management, increased awareness among consumers of diabetes risk factors and how to prevent or reverse diabetes, and medical plan design that removes barriers to appropriate care.
"There is a lot of confusion and distrust around the sometimes conflicting individual health plan quality reports physicians receive," said Scott Conard, MD, president of Medical Affairs, Medical Edge Healthcare Group. "While reports based on claims data are not perfect, these aggregated, five-plan reports are a good first step toward eliminating some of this confusion."
The Diabetes Care Reports are the result of a year-long collaboration of key stakeholders including local physicians, employers, consumers and health plans who worked together to develop workable care measurement and improvement strategies that are acceptable to all. Doctors were directly involved in selecting the performance metrics used in designing the reports. The initial reports, developed only for the physicians and not being made public at this time, are intended to begin a dialogue with physicians on how to increase public awareness of diabetes risk factors and prevention, and to improve diabetes care and outcomes in the DFW area.
"The real value of this exercise is the way it has brought physicians, employers, consumers and health plans together in frank and open discussion to grapple with the obstacles to making diabetes care the best it can be in DFW," said Bob Queyrouze, internal consultant for Compensation, Benefits, Health & Productivity Management, Federal Reserve Bank of Dallas. "Effective solutions will only be possible with action from all of the stakeholders involved."
Impact of diabetes in Dallas-Fort Worth
About 400,000 people have been diagnosed with diabetes in the Dallas-Fort Worth 12-county area (about seven percent of the total 6 million population). And according to the American Diabetes Association, about a quarter of those with diabetes don't even know they have it, which would equate to another 133,000 area residents who have undiagnosed diabetes.
Aggregating data across the five health plans provides a larger sample of patients and a broader, more statistically significant view of the care a physician's diabetes patients received in 2007. Consistent measurement criteria and methodology across the five health plans provides meaningful comparisons of individual physician results to community-wide averages. The PPHP and the health plans can compare data between health plans to identify ways to improve the collection and reporting of quality data, as well as evaluate how different health plan designs may affect access to care, care management, and patient compliance.
About The Partnership for Peak Healthcare Performance
The Partnership for Peak Healthcare Performance involves approximately 80 percent of the nearly 4,100 primary care physicians in the DFW market and their patients through the provider networks of the five participating health plans -- Aetna, Blue Cross and Blue Shield of Texas, CIGNA, Humana and UnitedHealthcare -- and nearly 300,000 local employees of the DFWBGH member companies and their family members.
About the Dallas-Fort Worth Business Group on Health
The Dallas-Fort Worth Business Group on Health is a 145-member coalition of Dallas and Fort Worth area employers committed to market-based health care reform. Members include American Airlines, Bell Helicopter-Textron, Brinker International, Federal Reserve Bank of Dallas, JC Penney, Neiman Marcus, Sabre Holdings, Southwest Airlines, and Texas Instruments. A member of the National Business Coalition on Health, the DFWBGH's goals are to empower employers to make informed health care purchasing decisions and to encourage health care providers to continuously improve their performance
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