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Related Experiment Videos

Using a quality scorecard to measure and improve medical groups' performance.

M J Belman1, L Payne-Simon, E Tom

  • 1Blue Cross of California, Woodland Hills 91367, USA. michael.belman@wellpoint.com

The Joint Commission Journal on Quality Improvement
|May 26, 1999
PubMed
Summary

A structured quality improvement intervention significantly boosted performance for underperforming medical groups and IPAs. Key areas like quality audits and member satisfaction showed notable gains.

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Area of Science:

  • Healthcare Management
  • Quality Improvement Science
  • Health Services Research

Background:

  • Blue Cross of California (BCC) utilizes an annual Quality Scorecard to assess participating medical groups (PMGs) and independent practice associations (IPAs).
  • The scorecard informs PMGs/IPAs of their performance across various domains relative to network averages.
  • Financial incentives (bonuses) are provided to PMGs/IPAs demonstrating superior quality performance.

Purpose of the Study:

  • To design and implement a structured intervention aimed at enhancing the performance of PMGs/IPAs identified as low performers on the Quality Scorecard.
  • To evaluate the impact of this targeted intervention on specific quality metrics.

Main Methods:

  • A cohort study was conducted within a large California health maintenance organization in 1997.

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  • Twenty-two underperforming PMGs/IPAs (scoring more than 1 standard deviation below the mean) were identified and targeted for intervention.
  • These targeted groups received detailed feedback on their performance, supplementary information on deficient areas, and direct assistance from a BCC quality team.

    • Main Results:

    • Targeted PMGs/IPAs demonstrated significant improvements in their annual audit of quality scores.
    • Member satisfaction metrics, including satisfaction with access, last visit, and overall experience, showed marked improvement.
    • Performance in mammography screening and the overall total quality score also saw significant positive changes.

    Conclusions:

    • A structured quality improvement intervention effectively addressed deficiencies in poorly performing PMGs/IPAs.
    • The intervention led to measurable improvements across several critical performance indicators, highlighting the efficacy of targeted support.