Informed inquiry into practice variations: the Maine Medical Assessment Foundation

This paper reports on the development of a successful physician organized and driven medical assessment program, the Maine Medical Assessment Foundation. Responding to the issues and challenges presented by practice pattern variation in the state of Maine, eight physician specialty study groups have been developed in the state over the past ten years. Working in a confidential, educational, non-regulatory format, study groups have had remarkable success in providing feedback of epidemiologic data on area variations to practitioners. This process has succeeded in modifying practice patterns, resulting in marked improvements in quality of care and decreases in apparently excessive utilization of health care resources. Simultaneously, physicians have become supporters of the process of small area analysis and they have joined in community based outcomes research projects. This successful program can be a model for other areas.