Quality Insights: Healthcare Performance in Massachusetts

What is quality healthcare?

Massachusetts Health Quality Partners (MHQP) is an independent organization that looks at the quality of healthcare in Massachusetts. It does so through the use of claims-based clinical data that compares side-by-side how different medical groups across Massachusetts treat the same type of illness or health condition.

MHQP also looks at the quality of healthcare through the patient experience. Patients complete surveys and tell us what it is like to work with their doctors. This information is then used to compare patients' experiences across the state.

MHQP healthcare quality data has been shared with doctors and health plans since 2004. Since 2005, MHQP has been pleased to share this data with patients, their family members, and the general public.

How can healthcare quality data help patients and their family members?

Patients and their family members can use MHQP information to:

• Learn about differences in the quality of healthcare. This is important because not all doctors' offices treat patients the same way.
• Choose a doctor. This may happen when people move to Massachusetts, doctors retire and move away, or people just want to change doctors.
• Feel empowered. This is when patients and their family members feel more in control of their healthcare.

What is meant by the term "quality healthcare"?

"Doing the right thing, at the right time, for the right person, and having the best possible result" is a definition of quality healthcare used by the federal Agency for Healthcare Research & Quality (AHRQ).

Quality healthcare, as explained by the Institute of Medicine, means treatment and care that is:

• Safe. Treatment helps patients and does not cause harm.
• Effective. Research shows that treatments have positive (good) results.
• Patient-centered. Healthcare providers (doctors, nurses, and others) treat all patients with respect. This means taking into account each patient's values about health and quality of life.
• Timely. Patients get the care they need at a time when it will do the most good.
• Efficient. Treatment does not waste doctors' or patients' money or time.
• Equitable. Everyone is entitled to high quality healthcare. This includes men and women of all cultures, income, level of education, and social status.

How do people get healthcare in Massachusetts?

People in Massachusetts get healthcare through a system of doctors, doctors' offices, and medical groups. Here is information about each part of the healthcare system, along with pictures used throughout this website:

	Doctors. Almost all patients get at least part of their care from doctors. This includes primary care physicians as well as other doctors who treat patients, provide care, or give medical advice.
	Doctors' offices. These are the places where doctors treat patients. Some offices are quite large with 50 or more doctors. Others are small with as few as 3 doctors. Some doctors work at more than one office. Often, doctors work with nurse practitioners, physician assistants, and other providers to treat patients in their office.
	Medical groups. These are organizations that employ or contract with doctors, nurses, therapists, and others who treat and care for patients. Medical groups vary in size and the kind of services they offer. Some groups are small with just one doctor's office. Others are large with many doctors' offices in a medical group.

What data is in this MHQP report?

This report includes two types of healthcare quality data:

	Clinical data for medical groups. This looks at how patients are treated by doctors from all offices in a medical group. MHQP does not compare doctors side-by-side, as the numbers may be too small to be accurate. Someday, MHQP plans to compare clinical quality information from all doctors' offices.
	Patient experiences in doctors' offices. This looks at how patients assess all (not just one) of the doctors working in the same office. Someday, MHQP plans to have quality data about each doctor working in an office.

How can people help improve the quality of their healthcare?

• Ask questions. Make a list of all the questions you want to ask. Bring this list to each appointment and write down the doctor's answer. If you do not understand, ask again until you do.
• Give your doctor complete and accurate health information. This includes your health history (diseases you or others in your family have); medication history (medicines, over-the-counter drugs, and herbals you take); and lifestyle (whether you smoke, drink, or use street drugs).
• Talk with your doctor about what matters to you. This includes your values about medical treatment and quality of life.
• Speak up when there are problems. Tell your doctor if, at any time, you feel that you are not getting quality healthcare.

For more information on what you can do to improve the quality of your healthcare, see Quick Checks for Quality: Choosing Quality Health Care, an information sheet by the Agency for Healthcare Research and Quality (AHRQ). You can also visit the Partnership for Healthcare Excellence's website for fact sheets and local resources on healthcare quality specific to Massachusetts. The Partnership is dedicated to helping Massachusetts consumers improve the quality of their healthcare.

How do I choose a doctor?

Most patients have a primary care physician. This can be a family doctor, internist, pediatrician or general practitioner. Your primary care physician helps you stay healthy and coordinates care when you are sick. He or she will also refer you to specialists (such as allergists, cardiologists, or surgeons) when needed.

Doctors are not all the same -- they vary in terms of training, expertise, and the quality of care they give. Here are some things to do when choosing a doctor:

• Make a list of the qualities you want in a doctor. This may include the doctor's training, experience, credentials, personal or "bedside" manner, availability (how quickly you can get an appointment), hospital affiliation, and languages spoken. You can often find out this information by going to the Massachusetts Board of Registration in Medicine.
• Ask for referrals. Get opinions about doctors from people you trust. This may be friends, family, other doctors, medical society, health plan, or your local hospital.
• Talk to staff in the doctor's office. Ask whether the doctor is taking new patients, what hours the office is open, how long it takes to get routine appointments, and ways emergencies are handled.
• Find out who works with the doctor. Some doctors work with nurse practitioners, physician's assistants, and others to take care of patient's needs. Ask who else treats patients and how they work with the doctor.
• Find out about the doctor's network of care. This includes specialists, hospitals, and medical groups the doctor works with and could refer you to. Also consider your comfort level with the size of the doctors' office, such as whether you prefer a small doctors' office or a larger site, where many doctors work together.
• Meet the doctor. Make an appointment to meet the doctor you are thinking about working with. Talk about what matters to you and decide whether this is a doctor you trust and feel comfortable working with.
• Compare quality information. Use information from this website to compare how medical groups and doctors' offices do in areas that matter to you.

For more information about choosing a doctor, visit What You Can Do to Choose the Right Doctor for You by the Partnership for Healthcare Excellence.

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