Public reporting on the quality of ambulatory health care is growing, but knowledge of how physician groups respond to such reporting has not kept pace. We examined responses to public reporting on the quality of diabetes care in 409 primary care clinics within seventeen large, multispecialty physician groups. We determined that a focus on publicly reported metrics, along with participation in large or externally sponsored projects, increased a clinic’s implementation of diabetes improvement interventions. Clinics were also more likely to implement interventions in more recent years. Public reporting helped drive both early implementation of a single intervention and ongoing implementation of multiple simultaneous interventions. To fully engage physician groups, accountability metrics should be structured to capture incremental improvements in quality, thereby rewarding both early and ongoing improvement activities.
Public reporting of performance on quality measures is increasingly
common but little is known about the impact, especially among physician groups.
The Wisconsin Collaborative for Healthcare Quality (Collaborative) is a
voluntary consortium of physician groups which has publicly reported quality
measures since 2004, providing an opportunity to study the effect of this effort
on participating groups. Analyses included member performance on 14 ambulatory
measures from 2004–2009, a survey regarding reporting and its
relationship to improvement efforts, and use of Medicare billing data to
independently compare Collaborative members to the rest of Wisconsin,
neighboring states and the rest of the United States. Faced with limited
resources, groups prioritized their efforts based on the nature of the measure
and their performance compared to others. The outcomes demonstrated that public
reporting was associated with improvement in health quality and that large
physician group practices will engage in improvement efforts in response.
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