Maureen A. Smith, M.D., Dr.P.H., Alexandra Wright, M.S., Christopher Queram, M.H.S.A., and Geoffrey C. Lamb, M.D.
M. A. Smith, A. Wright, C. Queram et al., “Public Reporting Helped Drive Quality Improvement in Outpatient Diabetes Care Among Wisconsin Physician Groups,” Health Affairs, March 2012 31(3):570–77.
A survey of more than 400 primary care clinics that have been publicly reporting data on how well they deliver diabetes care found that such public reporting helped drive early adoption of diabetes care improvement activities, including patient registries and care reminders. Public reporting also seems to have promoted the adoption of multiple improvement interventions over time.
Although quality-of-care data for physician groups have been publicly reported for some time, little is known about how physicians respond to this feedback. With Commonwealth Fund support, researchers sought to assess the link between public reporting on diabetes care and physicians’ activities to improve the quality of care they provide to patients. The study team focused on doctors participating in the Wisconsin Collaborative for Healthcare Quality, an organization of physician groups that has been publicly reporting performance data for diabetes care since 2004. Physicians in this group represent about half of the state’s primary care physicians, and have been shown to provide better care at lower costs than their peers.
To engage physician groups most effectively, “accountability metrics should be structured to capture incremental improvements in quality,” the researchers say, “thereby rewarding both early and ongoing improvement activities.” Public reporting seems to have encouraged clinics with no prior quality improvement experience to “get off the sidelines” and engage in an initial improvement activity.
The study authors surveyed 409 primary care clinics within 17 large, multispecialty physician groups participating in the Wisconsin Collaborative for Healthcare Quality. Clinics were asked about their diabetes care improvement interventions, as well as their organization and infrastructure. The primary outcome measure was the number of interventions implemented from 2003 to 2008, out of 22 possible interventions drawn from the chronic care model.
Public reporting seems to have driven early adoption of diabetes care improvement interventions and the adoption of multiple, simultaneous interventions over time.