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Improve Your Care

About the Primary Care Practice Quality Data

 

The Primary Care Practice Performance Report At-a-Glance

Kansas City Quality Improvement Consortium 
KCQIC partners with Kansas City health providers to produce the community Primary Care Practice Performance Report. The Alliance is a collaborative involving employers, physicians, hospitals, health plans, patients and others working to improve quality and efficiency while reducing the rate of health care costs. 

The Primary Care Practice Performance Report
The Primary Care Practice Performance Report shows how often patients in the Kansas City area get recommended health care from doctors. The report looks at many health care topics, including diabetes, depression and asthma. 

What can you learn from the report?
Not all health care is the same and our local health care can be better. The report shows that some patients aren't getting the basic types of care that doctors agree they should. For example, the report showed that a significant number of people with back pain (46 percent) received back X-rays prematurely. This information will be used by health providers and patients to address this concern. 

How can you use this report?
Use the report to talk with your doctor about what you need to be safe and healthy - then do it! Go to the "Resources" page of the site to find tools and ideas to help you manage your health care. 

About the Primary Care Practice Quality Data
The Kansas City Quality Improvement Consortium (KCQIC) is a community collaborative that includes area health plans, physician groups and individual physicians, the UAW-Ford Community Health Care Initiative, area medical schools, the Kansas and Missouri Quality Improvement Organizations, and consumer networks. KCQIC is a member of the Robert Wood Johnson Aligning Forces for Quality Initative.  

What is the Primary Care Practice Performance Report?
The Primary Care Practice Performance Report provides data on the quality of care provided by primary care physician groups in the greater Kansas City area. Information for the 2008 report was provided by six commercial health plans which also included two managed Medicaid health plans. The 2009 and 2010 data was provided by Kansas City health plan partners including, Blue Cross Blue Shield of Kansas City, CIGNA, Coventry, Humana, and United Healthcare. This information is based on claims received from primary care physician offices. These claims were for HMO (Health Maintenance Organization) patients only and did not include patients with Medicare, Medicaid or other health plans. The 2011 and 2012 data included HMO and PPO (Preferred Provided Organization) plan data provided by Blue Cross Blue Shield of Kansas City, CIGNA, Coventry and Humana. The data did not include information from Medicaid or Medicare.  

The measures used in this report were selected by the KCQIC community collaborative and are nationally approved measures of quality care. The report shows how often patients get  effective care or care that the medical community agrees works best to promote better health for chronic conditions such as diabetes, asthma, depression and heart disease. 

Our reports are like report cards for medical practices. The reports tell you how a practice did at giving care for certain medical conditions during a particular year, like a grade that you would have received in school. This generally represents a relatively low percentage of a practice's total patient population. Our reports do not tell you how each practice does taking care of all their patients for all medical conditions.

Measuring practice performance is difficult, and our health care system is just beginning to learn how to do it. Much of the performance data is derived from medical claims. There are limitations to the use of health plan claims data for measuring quality. For example, claims data do not show every aspect of care: there is no billing, procedure, or diagnosis code for certain health services or problems, so some information does not appear in claims. Another example is the timeliness of the data: While everyone would prefer to show very recent data, there will always be lag time when using claims data due to the steps involved in billing and payment, and time to combine information and determine the results. 

KCQIC works in partnership with health care providers to address the public reporting process. Primary practices are asked to review their results before data is shown on the website. The goal is to provide a comprehensive public report that will help improve the quality of health in the Kansas City community. Kansas City health providers want to improve the care they provide to patients and they want Kansas City consumers to make informed decisions about their own health care. 

How can you use this report?
Patients and their family members can use this information to:

  • Learn about differences in the quality of health care. This is important because there is a large variation in quality of care.
  • Choose a doctor. This information is useful when people move, doctors retire and move away, or people just want to change doctors.
  • Become an E-patient educated and empowered. Take an active role in your health care. Use the report to talk to your doctor about what you need to do to stay healthy. Use our resources to find tools to take action and make more informed healthcare choices.