Rewarding Results: Aligning Incentives with High-Quality Health Care

What We Did:

MHQP led one of seven projects funded by The Robert Wood Johnson Foundation (RWJF) to evaluate
the impact of incentives on physician performance.

MHQP’s work was focused primarily on building the infrastructure necessary to enable the transparent reporting of physician performance in order to study the impact of public reporting on high quality performance. We aggregated clinical effectiveness data across the five major health plans in Massachusetts and developed a centralized source of quality performance information that could be used to evaluate the impact of incentive programs developed and administered by the plans and provide physicians and the general public with feedback on physician performance based on uniform measures.

The project drove the creation of foundational infrastructure that has been critical for assessing and comparing provider performance in Massachusetts. Specifically, through this project, MHQP:

  • Created the Massachusetts Provider Directory (MPD), the first master directory of all primary care physicians who contracted with the 5 Massachusetts health plans, which we have continued to update annually.
  • Aggregated 2001 – 2004 HEDIS performance data from all 5 plans for all physicians in the MPD.
  • Aggregated individual physician data to create practice site, medical group and physician network results for each HEDIS measure for each year.
  • Created comparative reports at practice sites, medical group and network levels each year and shared that information with each medical group and network.
  • In 2005, released Massachusetts’ first annual statewide public reporting of physician performance data on the MHQP website, providing performance information for the state’s nine large physician networks and allowing consumers to compare the networks on 16 quality measures.
  • In 2006, issued a second set of data, providing performance measures at the medical group level and allowing consumers to compare approximately 150 groups statewide.

Who Was Involved:

This project was funded by RWJF and involved active participation from all five major Massachusetts health plans (Blue Cross Blue Shield of Massachusetts, Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New England, and Tufts Health Plan) as well as provider organizations (Massachusetts Medical Society, Massachusetts Hospital Association, and Massachusetts Health Quality Partners Physicians Council) and government agencies (Massachusetts Division of Medical Assistance and Massachusetts Department of Public Health).

Why This Work Matters:

At the time of this project, no one was publicly reporting clinical quality data, and Massachusetts didn’t have the capability to do so. This project established MHQP as a national leader on physician performance reporting.

The Massachusetts Provider Directory (MPD) continues to be a pivotal resource for MHQP to publicly report performance data across the state.

MHQP began reporting clinical quality at the network level in 2005, at the medical group level in 2006, and expanded the reach of these reports with the launch of our consumer-facing website in 2013,

The transparent reporting of provider quality and experience data has become common practice in healthcare based on MHQP’s pioneering efforts.

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