Comments on: “Damn Yankees” Do It Again? by Dolores Mitchell http://commonhealth.wbur.org/dolores-mitchell/2007/09/damn-yankees-do-it-again-by-dolores-mitchell/ CommonHealth Fri, 19 Mar 2010 17:52:41 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: Dolores Mitchell http://commonhealth.wbur.org/dolores-mitchell/2007/09/damn-yankees-do-it-again-by-dolores-mitchell/comment-page-1/#comment-3382 Dolores Mitchell Thu, 06 Sep 2007 16:58:07 +0000 http://www.wbur.org/weblogs/commonhealth/?p=203#comment-3382 To continue my baseball metaphor, Dr. Magee’s suggestion that analyzing physician performance on a real time basis rather than looking at performance over time would be roughly like deciding which team should be designated the league champion on the basis of yesterday’s game and ignoring the whole season and its attendant statistics. Dr. Magee knows full well that fairness demands looking at a large data set, aggregating a statistically significant number of physician encounters, and then, and only then, making judgments about performance. On his other concern, let me assure him that the GIC is, in fact, tracking the results of our provider profiling program. We are doing our own tracking; our data vendor, Ingenix, is developing metrics to evaluate the program’s performance; our consultant, Mercer Human Resources will specifically be looking for any unintended consequences; and we are currently in conversation with a nationally recognized health economist from one of our prestigious universities to do a longitudinal analysis of the program. Having said all that, our readers should know that Dr. Magee and two of his Mass Medical Society colleagues are active participants in our physician advisory group --- they are, and will continue to be, part of our ongoing commitment to providing continually improving direct-to-physician reports. To continue my baseball metaphor, Dr. Magee’s suggestion that analyzing physician performance on a real time basis rather than looking at performance over time would be roughly like deciding which team should be designated the league champion on the basis of yesterday’s game and ignoring the whole season and its attendant statistics. Dr. Magee knows full well that fairness demands looking at a large data set, aggregating a statistically significant number of physician encounters, and then, and only then, making judgments about performance.

On his other concern, let me assure him that the GIC is, in fact, tracking the results of our provider profiling program. We are doing our own tracking; our data vendor, Ingenix, is developing metrics to evaluate the program’s performance; our consultant, Mercer Human Resources will specifically be looking for any unintended consequences; and we are currently in conversation with a nationally recognized health economist from one of our prestigious universities to do a longitudinal analysis of the program.

Having said all that, our readers should know that Dr. Magee and two of his Mass Medical Society colleagues are active participants in our physician advisory group — they are, and will continue to be, part of our ongoing commitment to providing continually improving direct-to-physician reports.

]]> By: B. Dale Magee, M.D., M.S., President, Massachusetts Medical Society http://commonhealth.wbur.org/dolores-mitchell/2007/09/damn-yankees-do-it-again-by-dolores-mitchell/comment-page-1/#comment-3376 B. Dale Magee, M.D., M.S., President, Massachusetts Medical Society Thu, 06 Sep 2007 13:49:33 +0000 http://www.wbur.org/weblogs/commonhealth/?p=203#comment-3376 There is no doubt that more accurate information about health care serves all involved better. The key word here is “accurate.” What concerns us at the Medical Society has more to do with the fact that using medical bills as a source of clinical information is fraught with inaccuracies. Providing patients with more information is an important goal, but only if that information is truly useful in helping to make decisions. Providing physicians with more information also is an important goal, but only if that information is truly actionable. We agree that the plans have a great deal of information that has the potential for improving health care delivery. But generating reports years after the fact using data that has not even been verified by the doctors involved is not the way. If cost is truly an issue why not make the cost of the care that doctors order available to them real time? What person could control their budget if all that they had to go by was a note stating that they overspent two years ago and they shopped in a market with no prices on the products? This is how the guts of the GIC’s tiering program works. Managed care companies will advance the promise to “manage care” when they more actively partner with the doctors who take care of patients and provide information that they can use to improve patient care. We know that when doctors push for release of the details of their data they are finding that they have been misclassified. We know that the results of just a few patients can move a doctor from one category to another. And, we also know that no one is keeping track of this experiment to see if anyone is being harmed by it. Some transparency! There is no doubt that more accurate information about health care serves all involved better. The key word here is “accurate.” What concerns us at the Medical Society has more to do with the fact that using medical bills as a source of clinical information is fraught with inaccuracies.

Providing patients with more information is an important goal, but only if that information is truly useful in helping to make decisions.
Providing physicians with more information also is an important goal, but only if that information is truly actionable.

We agree that the plans have a great deal of information that has the potential for improving health care delivery. But generating reports years after the fact using data that has not even been verified by the doctors involved is not the way. If cost is truly an issue why not make the cost of the care that doctors order available to them real time? What person could control their budget if all that they had to go by was a note stating that they overspent two years ago and they shopped in a market with no prices on the products? This is how the guts of the GIC’s tiering program works. Managed care companies will advance the promise to “manage care” when they more actively partner with the doctors who take care of patients and provide information that they can use to improve patient care.

We know that when doctors push for release of the details of their data they are finding that they have been misclassified. We know that the results of just a few patients can move a doctor from one category to another. And, we also know that no one is keeping track of this experiment to see if anyone is being harmed by it. Some transparency!

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