The Madison Alliance produced a brochure plus this printed report on the quality of medical groups. Example provided by the Employers Health Care Alliance.
Quality Counts™, Consumer Information for Better Health Care, is a service of the Employer Health Care Alliance.
The Medical Group Report is part of QualityCounts™, the Alliance's ongoing effort to bring health care quality information to consumers. The report compares the quality of medical groups in Madison and south-central Wisconsin—and identifies variations in performance that demonstrate opportunities for improvement. For the Alliance, the report is an important first step in bringing consumers information that helps them get care that's right for them.
In many ways, the U.S. health care system is one of the best in the world. But its quality is uneven. In a recent report, the Institute of Medicine estimated that between 44,000 and 98,000 Americans die each year from medical errors—more than the number who die from traffic accidents, AIDS, or breast cancer annually.
Even when errors don't result in death, health care is often delivered inconsistently. Patients frequently fail to receive basic treatments that are known to reduce risk, such as eye exams for people with diabetes. Or they receive treatments that aren't the best option for their conditions—for example, one out of every six hysterectomies performed each year is considered to be unnecessary (Institute of Medicine, 1998).
The Alliance is a group of 1,500 large and small employers in the Madison area. These companies work together to provide access to high-quality health care and help employees make better health care choices. The QualityCounts™ Medical Group Report is part of this effort. Employer members of the Alliance include Chorus Communications, EconoPrint, Land's End, Madison Gas and Electric Company, Madison Newspapers Inc., Rayocvac, Trek Bicycle Corp. and the Wisconsin Education Association Insurance Trust (WEAIT).
Measuring health care quality and creating information from consumers is a complex and relatively new effort. This year's Medical Group Report focuses on patient satisfaction information.
More than 106,000 employees and family members receive health care coverage through companies that are members of The Alliance. The Medical Group Report compares the performance of the 12 medical groups these people use most often:
Dane County
Associated Physicians
Dean Medical Center (Dane County locations only)
UW Health-Physicians Plus (Dane County locations only)
UW Health-University Physicians ((Dane County locations only, does not include family practice doctors. )
Green County
Monroe Clinic
Iowa County
Family Practice Associates SMDV
Mineral Point Medical Center
Rock County
Mercy Medical Center
Riverview Medical Center
Sauk County
Baraboo Medical Associates SMDV
Prairie Clinic
Reedsburg Physicians Group
To date, most National and regional health care comparisons have focused on performance at the health plan level. HEDIS, for example—administered by the National Committee for Quality Assurance—is one of the best known measurement systems for HMO comparisons.
The Alliance is one of several business coalitions working to measure and report on medical group quality—a level where options are greater and decisions more complex for most consumers. Others include the Buyer's Health Care Action Group in Minnesota and the Pacific Business Group on Health in California.
The Medical Group Report shows consumers how satisfied patients are with the care and service they receive from primary care doctors and clinic staff. The report looks at medical group quality in five areas:
Doctor communication and care
Clinic service
The report also compares the performance of local medical groups to National benchmarks where available. These benchmarks reflect results for the highest-scoring health plans in the Nation that have used this survey. You'll see benchmarks for the two rating items and for the individual items that make up the three composites—doctor communication, getting care quickly, and staff service.
The Alliance used a survey called the Consumer Assessment of Health Plans Survey—CAHPS®—developed by the United States Agency for Healthcare Research and Quality. The tool, designed for use with health plans, has been tested and validated for use at the medical group level. The Alliance hired an independent company to conduct the CAHPS® survey in the fall of 1999.
The survey was sent to 6,000 Alliance member employees in south-central Wisconsin who had visited a primary care doctor in the last 12 months. For this report, primary care doctors include specialists in family practice, internal medicine, obstetrics-gynecology, and geriatrics. (Results for UW Health-University Physicians do not include family practice physicians.) The results in the report are based on answers from approximately 300 patients of each medical group. The survey results show how satisfied these patients are with their medical groups.
While satisfaction is an important measure of quality, it doesn't provide a complete picture. Over time, the Alliance will bring consumers information on other important measures—like how well doctors provide preventive care and care for chronic illness.
The Alliance encourages consumers to use the report in two ways—to select a new medical group or check the performance of the group they're already using. The report stresses the importance of a positive patient/doctor relationship and urges consumers to talk to their doctors about quality and the comparisons in the report.
Alliance members are sharing the Medical Group Report with their employees and with the broader community. A summary version of the report is available from Alliance members and at public locations throughout the community. The information will be printed in the newspaper, broadcast on TV, distributed through the Madison Public Libraries and posted on the Alliance's quality information Web site at www.qualitycounts.org. The alliance is encouraging community groups and the media to help people obtain, understand, and use the report.
This section provides complete results for all the CAHPS® survey items used in the Medical Group Report, including individual item results that were not reported in the summary version.
Under each category, results for the composites are shown first, followed by results for the component questions that make up that composite. The two rating items—Doctor and Health Care—are based on single questions and are shown alone. Each chart is preceded by the CAHPS® survey question and response set on which the results were based.
The category descriptions and display format—divided bars with percentages—were influenced by a variety of qualitative research with consumers conducted by the Alliance, CAHPS®, and FACCT—The Foundation for Accountability. To make the results easier for consumers to understand, responses for each question were collapsed into three groups, based on the CAHPS® methodology. These response groupings were given consistent labels of "excellent," "good," and "fair/poor."
The benchmark scores in each chart reflect results for the highest-scoring health plan in the Nation that has used the CAHPS® survey. You'll see benchmarks for the two rating items and for the individual items that make up the three composites—doctor communication, getting care quickly, and staff service. Benchmark results aren't available at the composite level.