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Quality of care at participating medical groups jumps significantly MOUNTLAKE TERRACE, Wash. – Dec. 9, 2004 – Premera Blue Cross and several prominent medical groups from across Washington state today announced details of a three-year effort aimed at providing greater insight into key metrics of health-care quality, satisfaction and efficiency. Preventive screenings, diabetes monitoring and treatment, use of cost-effective generic drugs, and satisfaction with thoroughness of treatment were among the 17 variables measured by Premera’s 2004 Quality Score Card, results of which were announced today for the first time and are available at "This collaborative effort focused on providing information to the public about quality measurements in health care represents the future of medicine," said David F. Dreis, MD, Medical Director of Clinical Outcomes at Virginia Mason Medical Center. "This is an exciting initiative for Washington." Several prominent Washington medical groups participated in development of the Quality Score Card, including The Rockwood Clinic; Physicians Clinic of Spokane; Wenatchee Valley Medical Center; the Everett Clinic; Virginia Mason Medical Center; Pacific Medical Centers; and The Polyclinic. “Increasingly, consumers and providers are seeking information to make more informed health-care decisions.” said Mark Sollek, MD, a board-certified nephrologist and Premera medical director who heads up the Quality Score Card initiative. “While some quality benchmarks exist, they are national metrics developed in closed Health Maintenance Organization (HMO) settings where all doctors work for the same organization.” “The Quality Score Card is generating the first benchmarks in the Northwest developed by and for physicians with support from a major health plan, that track quality in an open PPO (Preferred Provider Organization) environment where most people get their commercial health coverage,” Dr. Sollek said. Improvements in Quality of Care Deployment of the Quality Score Card has also coincided with a marked improvement in health-care quality by participating medical groups. In the first two years, participating medical groups improved quality by 16 percent in areas with greatest opportunity for improvement. “You can’t improve what you can’t measure,” said William Gotthold, MD, Medical Director for the Wenatchee Valley Clinic. “We credit Premera for making this a collaborative effort rather than imposing its own standards on the medical community. By working together and learning from each other, we can accelerate efforts to improve quality.” Beginning in 2001, participating medical groups and Premera worked with national standards to identify key indicators of health-care satisfaction and quality in several areas from preventive medicine to acute care. These key indicators include:
  • Critical screening exams for women including breast and cervical cancer. Studies show mammograms may lower the chance of dying from breast cancer by 25 percent to 35 percent.
  • Monitoring and treatment of diabetes. Diabetes is reaching epidemic proportions and accounts for a significant percentage of health care costs.
  • Usage of cost-effective generic drugs. On average, generic equivalents cost about 30 percent less than their brand-name counterparts during the first year they become available—and often reach a 75 percent cost savings within two years.
Using claims data from each clinic’s patients, Premera’s Quality Score Card tracks how often a participating medical group’s patients receive “best-practice” care. Using the same approach, Premera also compared these aggregated results to an aggregated average for other Washington clinics. In this way, participating medical groups were able to gain important insights into how their practices compared to their peers – and where innovative solutions existed. By focusing on best opportunities for improvement, participating medical groups substantially improved performance in areas where scores were lower, without sacrificing higher levels of quality elsewhere. “These clinics and Premera believe quality is a joint venture for practitioners, consumers and health plans,” Dr. Sollek said. For each quality indicator, the Quality Score Card offers practical consumer tips and resources that consumers can use to improve their own health-care quality. “Most importantly, the Quality Score Card was developed by and for physicians, with Premera’s support,” said Mike Tronolone, MD, medical director for The Polyclinic in Seattle. “We hope it yields information that supports on-going efforts to improve health-care quality and cost-effectiveness.” 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 in Washington and Alaska. 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, in multiple western states.
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