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Medicare News
Medicare Begins Program to Help Seniors Choose Best
Quality Doctors
Begins comparing physician performance data with
insurance companies
 Feb. 15, 2007 – Medicare today announced a program
to combine data from insurance companies with that of Medicare patients
to produce information on the performance of health care providers,
which the Centers for Medicare & Medicaid Services says will "benefit"
Medicare beneficiaries by helping them choose the best performing
doctors.
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CMS announced that the Delmarva Foundation for
Medical Care (Delmarva), one of its quality improvement organizations,
has entered into subcontracts with four regional collaboratives, as part
of the Better Quality Information to Improve Care for Medicare
Beneficiaries (BQI) Project.
These regional collaboratives will combine the
data.
The following regional collaboratives have signed
subcontracts: Indiana Health Information Exchange (IHIE), Massachusetts
Health Quality Partners (MHQP), Minnesota Community Measurement (MNCM),
and Wisconsin Collaborative for Healthcare Quality (WCHQ).
The results of the BQI Project will be used for two
primary purposes: first, to provide performance information to
physicians that will assist them in improving the quality of care they
are delivering to Medicare beneficiaries; and second, to give physician
performance information to Medicare beneficiaries in order to help them
with physician selection.
“This is an important advancement,” said CMS
Acting Administrator Leslie V. Norwalk.
“The BQI project will give Medicare beneficiaries a
broad overview of provider performance resulting in better choices in
meeting their health care needs. The regional collaboratives, spurred
by great leadership from physicians and others in the health care
community, will also provide critical information to physicians and
Medicare on the best practices for data collection, aggregation, and
reporting.”
The BQI Project is part of HHS Secretary Mike
Leavitt’s Value-driven Health Care Initiative which is based on the
following four cornerstones announced in President Bush’s Executive
Order issued August, 2006: interoperable health information technology
(health IT);
● transparency of price information;
● transparency of quality information; and
● the use of incentives to promote high-quality and cost-efficient
health care.
The Executive Order directs federal agencies, to
the extent permitted by law, to share information with beneficiaries on
the quality of services provided by doctors, hospitals, and other health
care providers.
The objective of the Initiative is to provide the
public and providers with reliable and consistent measures of quality
care. The subcontracts announced today will allow the BQI project to
apply these principles to the Medicare program.
The quality measures to be used in the BQI project
are national consensus-based measures that have been adopted by AQA (an
alliance of health care providers, health plans, senior groups,
employers and unions that also played a role in the establishment of the
subcontracting collaboratives).
For example, all people with Type 2 diabetes should
have a simple lab test twice per year that shows the average amount of
sugar in the blood over the last two to three months. Running this
measure will show how many of a physician’s diabetic patients received
this test and allow a physician to improve his or her performance if the
test is not being conducted as indicated.
The BQI project also aims to provide the most
effective methods to aggregate Medicare claims data with claims data
from other payers, including employers, health insurance plans and in
some case Medicaid programs, in order to produce more accurate measures
of the quality of services being provided by physicians to people with
Medicare. Combining public and private sector claims data will create a
more comprehensive view of the quality of care provided and enable
Medicare beneficiaries to make more informed health care decisions.
“The local entities selected to participate in the
BQI Project each bring a unique set of characteristics and experience
that will prove beneficial in the implementation and ultimate success of
the project,” Norwalk said. “Critical to our success in improving
health care quality is having a process where stakeholders can come
together on strategy and in working together to improve information on
physician performance.”
“I am grateful for the support from the Quality
Alliance Steering Committee, which includes colleagues from the Agency
for Healthcare Research and Quality (AHRQ), the AQA, and the Hospital
Quality Alliance as we work closely together to improve systems that
deliver information and efficient care to patients and avoid unnecessary
complications and costs,” said Barry M. Straube, MD, CMS Chief Medical
Officer and Director of CMS Office of Clinical Standards and Quality.
“The AQA has been at the forefront of this
initiative, continuing to lead efforts both on identifying quality
measures and how to report that information in a meaningful way.”
CMS plans to announce two additional BQI
subcontractors in the near future. Additional information on each
regional collaborative as well as the Secretary’s Value-driven Health
Care Initiative is available at
www.hhs.gov/transparency.
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