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Premera Blue Cross 2005 Quality Score Card: an Updated Snapshot of Health Care Quality in Washington

Posted on: Wednesday, 14 December 2005, 15:00 CST

Premera Blue Cross and prominent medical groups across Washington today announced results of the 2005 Premera Quality Score Card, a collaboration supporting better health and more sustainable costs by providing information health care professionals and consumers can use to improve the quality and cost-effectiveness of health care.

Preventive screenings, diabetes monitoring and treatment, use of cost-effective generic drugs, and satisfaction with thoroughness of treatment were among the 19 variables measured by Premera's 2005 Quality Score Card. Results are published online at www.premera.com.

For the first time, the 2005 Quality Score Card includes performance on a group of important health outcomes -- revealing potentially dramatic improvements in control of diabetes.

In 2005, medical group participation in this collaborative effort nearly doubled, creating a robust view of health care quality in Washington. Participating medical groups reach an estimated one third of Premera's Washington members. Every participating medical group was among the top three performers in at least one area. The Score Card also estimates performance for physicians statewide.

Participating medical groups include Columbia Medical Associates; The Everett Clinic; Minor and James Medical; MultiCare Health Systems; Pacific Medical Centers; Pediatric Associates; Physicians Clinic of Spokane; The Polyclinic; Puget Sound Family Physicians; Rockwood Clinic; Virginia Mason Medical Center; Swedish Physicians; and Wenatchee Valley Medical Center.

Diabetes Control Improving

New to the 2005 Quality Score Card are three scores that reveal not just how often patients receive evidence-based standards of care, but also the resulting impact on health.

In 2003, a subset of participating medical groups began tracking key diabetes health indicators -- specifically, control of cholesterol, blood pressure, and ongoing blood sugar -- all highly correlated with better long-term health and lower medical costs. All participating clinics have been tracking these scores in 2005 for clinic-by-clinic publication next year.

"The Washington clinics chose to measure themselves against a higher level of performance than the minimum 'control' standards published by the National Committee for Quality Assurance (NCQA)," noted Dr. Mark Sollek, Premera Medical Director heading up the Quality Score Card project.

The results reveal dramatic improvements for these clinics' Premera patients from the previous year:

-- 51.3 percent of diabetic patients had well-controlled

hemoglobin A1c levels (at or below 7), nearly doubling the

previous year's performance.

-- 41.6 percent of diabetic patients had well-controlled

cholesterol levels (below 100), improving previous year's

performance by more than half; and

-- 38.6 percent of diabetic patients had well-controlled blood

pressure (at or below 130), improving previous year's

performance by nearly half.

"This is an early but exciting indicator," noted Dr. Sollek. "If this improvement can be sustained, it has the potential to reduce heart attacks, hospitalizations, amputations, strokes, blindness, kidney failure and premature deaths -- and represent significant savings in health care costs."

Studies have shown that every 1 percent drop in "A1c" levels reduces by 40 percent the risk of blindness, kidney failure and nerve disease and other vascular complications. Health care costs are up to 32 percent higher for diabetic patients with A1c levels greater than 10 compared to those whose A1c levels are 7 or lower.

Patients with well-controlled LDL cholesterol have 20 percent to 50 percent fewer strokes, heart disease and other cardiovascular complications. Blood pressure control reduces the risk of cardiovascular disease among people with diabetes from 33 percent to 50 percent, and the risk of vascular complications by 33 percent.

Quality Improvement: Patterns of Performance

Most participating medical groups in Washington state posted at least minor improvements on a majority of quality and satisfaction measures last year.

Quality Score Card participants tended to post performance scores 3 percent to 6 percent higher than the average of all other Washington state practices seeing Premera members last year.

Some of the greatest single-year improvements by individual participating clinics include:

-- 34 percent improvement in the recommended rate of well-child

visits for infants in the first 15 months of life.

-- 33 percent gain in use of appropriate blood pressure

medications for diabetes.

-- 14 percent improvement in the rate of generic prescribing

where a generic is available.

-- 12 percent improvement in the recommended rate of cholesterol

screenings for people with diabetes.

In most cases, declining performance reflected minor fluctuations in already high-scoring quality areas. One exception involved patterns of antibiotic usage. Recommended management of ear infections declined by 9 percent from the previous year, and for acute bronchitis, by 12 percent. Participating medical groups are using these results to examine why performance has declined and to determine what steps should be taken to address it.

The Quality Score Card also measures how much health care practices vary clinic by clinic and doctor by doctor. While recommended treatment of acute bronchitis occurred 34 percent of the time overall, some physicians may have delivered recommended care only 12 percent of the time, while others did so 74 percent of the time.

Building on a Solid Foundation

Participating medical groups say the Quality Score Card works because it was developed in a collaborative, trusted environment and tested with physicians for two years before the first results were published by Premera in 2004. In 2005, the collaborative approach used to develop Premera's Quality Score Card was recognized as a national best practice by the Blue Cross Blue Shield Association.

Using a collaboratively developed set of quality measures and measurement method, participating medical groups and Premera continue to work with other organizations in Washington state and nationally to drive to a more consistent "core" of set quality measures.

About Premera Blue Cross

Our mission is to provide peace of mind to our members about their health care coverage. We provide health insurance and related services to more than 1.3 million people. Premera Blue Cross has operated in Washington since 1933, and Alaska since 1957. Premera Blue Cross is an independent licensee of the Blue Cross Blue Shield Association.

Premera Blue Cross is a member of a family of companies based in Mountlake Terrace, Washington, that provide health, life, vision, dental, and long-term care insurance, and other related services.

Quality Score Card 2005 Media Contacts: Premera Blue Cross Scott Forslund, Director of Communications 425-918-5070 425-280-1653 (cell) scott.forslund@premera.com Chris Jarvis, Communications Manager 425-918-3368 206-714-4010 (cell) chris.jarvis@premera.com Columbia Primary Care Kelly Stanford, Director of Quality Improvement 509-744-3496 kstanford@columbiaprimarycare.com The Everett Clinic Catherine Russell, Media & PR Manager 425-304-1139 crussell@everettclinic.com Minor & James Medical Marty Francois, Practice Manager 206-386-9673 marty.francois@minorandjames.com MultiCare Health System Todd E. Kelley, Manager, Media Relations 253-403-1716 todd.kelley@multicare.org Pacific Medical Center Karyn Beckley, VP Marketing 206-621-4544 karynb@pacmed.org Pediatric Associates Bill Vandenberg, Administrator 425-460-5631 bvandenberg@peds-associates.com Physicians Clinic of Spokane David Page, Administrator 509-353-4264 dpage@physicians-clinic.com The Polyclinic Tracy Corgiat, Marketing & PR Director 206-860-4538 Tracy.Corgiat@Polyclinic.com Puget Sound Family Physicians Tim Turner, Associate Executive 360-568-1558 Director x120 SnoFamMed@netscape.net Rockwood Clinic Christine Eriksen, Marketing & PR 509-838-2531 Director x6232 ceriksen@rockwoodclinic.com Swedish Physicians Ed Boyle, Media Relations Director 206-386-2748 ed.boyle@swedish.org Lisa Tangen, Marketing & Communications 206-386-2791 lisa.tangen@swedish.org Virginia Mason Medical Center Kim Davis, Media Relations 206-583-6451 kim.davis@vmmc.org Wenatchee Valley Medical Center Mall Boyd, Marketing 509-664-4868 Director x5528 mboyd@wvmedical.com

Source: Business Wire

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