Washington state doctors lead their own quality appraisal

The program will link quality assessments with patient information, allowing physicians to follow up on care.

By Kevin B. O'Reilly, AMNews staff. Sept. 24, 2007.

Fresh from its battle against a local health plan's performance-based network, the Washington State Medical Assn. is close to issuing confidential reports that will allow physician members to examine how their quality measures up against their peers and best practice.

The Physician led Quality Improvement Program, or QUIP, is scheduled to deliver its first quarterly report in November. The report will include patient-identified pharmacy and claims data from public and private payers and will measure physician performance on clinical metrics for diabetes, cardiology, antibiotic use, depression, preventive care and asthma.

"What drove home the need to do this was the inaccuracies inherent in claims-made data," said W. Hugh Maloney Jr., MD, WSMA president. By tying the claims data to specific patients, physicians can check their office records to see if there are valid reasons why guideline-based care wasn't delivered. More important, Dr. Maloney said, the information becomes "actionable" for physicians.

"My vision is that as a general internist, if I had a list of 10 patients who have not had something done, I can put a tickler in each file to do it next time they come in, or send out a notice asking them to make an appointment," Dr. Maloney said.

The reports also are intended to give physicians a way to double-check a health plan's quality ratings and give them "ammunition" when contesting inaccurate performance rankings, he added.

The $1 million program comes on the heels of the association's recent settlement with Regence BlueShield that gives physicians greater involvement in designing a new tiered network based on quality and cost ratings. The state medical association, along with the AMA/State Medical Societies Litigation Center and six individual doctors, sued Regence in September 2006 to halt its Select Network, arguing that the payer's plan was based on faulty claims data.