Making Quality Count

Slide Presentation by Michael J. Belman, M.D., M.P.H.

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On February 18, 2004, Michael J. Belman, M.D., M.P.H., made a presentation in a Web Conference at Event 1, which was entitled "Using Measurement Data to Improve Quality."

This is the text version of Dr. Belman's slide presentation. Select to access the PowerPoint® slides (374 KB).

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Using Measurement Data to Improve Quality

Michael J. Belman, M.D., M.P.H.
Staff Vice President
Medical Director of Quality Management
Blue Cross of California
Woodland Hills, CA

Slide 1

Blue Cross of California (BCC) and its Approach to Quality

• 7 million members: PPO, HMO, and Medicaid
• HMO: 10 years of performance measurement
• 2002: multiple measures & financial incentive
• 2003: PPO physician quality incentive
• Goal: emphasize business case for quality

Slide 2

About the Consumer Assessment Survey (CAS)

• Measures satisfaction w/physician & medical group
• Derived from AHRQ-sponsored CAHPS® survey
• Random sample selected from each medical group
• Results presented in 4 domains:
  • getting needed care
  • getting care quickly
  • physician communication
  • overall rating

Slide 3

BCC Combines Tools to Measure and Promote Quality

• HMO report card combines
  • Clinical quality
  • Member satisfaction & perceptions of care (CAS)
  • Administrative service
  • Added points for internal group incentive program
  • Generic prescription performance
• Significant financial incentive tied to performance
• Profiles performance of about 160 medical groups/IPAs in California
• Reportcard on BCC web site

Slide 4

BCC and Pay 4 Performance Program has Major Impact

• Business case for quality:
  • Open Access Programs improve member satisfaction
  • Groups work to improve HEDIS performance
  • IT investment to improve medical and patient management
• Synergy with Integrated Healthcare Association (IHA) Pay 4 Performance (P4P)
  • Coalition of 6 major HMO plans in California
• P4P funded through RWJ grant

Slide 5

Keys to Positive Physician Reaction

• Measures important to physicians & member
• Clinical measures are well recognized - based on HEDIS specifications
• CAS survey seen as reliable & objective
• Administrative & service measures tied to contractual requirements
• Physician leadership input before implementation

Slide 6

BCC's CAS Results

• Bluecrossca.com > find a doctor or hospital > provider performance profile
• Healthscope.org > medical groups
  • Site of the Pacific Business Group on Health

Current as of June 2004

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Internet Citation:

Using Measurement Data to Improve Quality. Text Version of a Slide Presentation at a Web Conference. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/qcount/belmantxt.htm

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