Making Quality Count: Tools, Strategies, and Resources
Slide Presentation by Michael J. Belman, M.D., M.P.H.
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).
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
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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