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Related Experiment Videos

Reporting and using health plan performance information in Massachusetts

H S Jordan1, J H Straus, M H Bailit

  • 1Blue Cross Blue Shield of Massachusetts, North Quincy 02171-1794, USA.

The Joint Commission Journal on Quality Improvement
|April 1, 1995
PubMed
Summary

The Massachusetts Healthcare Purchaser Group's Cost/Quality Challenge provided valuable health plan performance data. This initiative demonstrated that purchaser/plan collaborations can yield crucial information for improving healthcare quality.

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Area of Science:

  • Healthcare Management
  • Quality Improvement
  • Health Services Research

Background:

  • Established in 1993, the Massachusetts Healthcare Purchaser Group (MHPG) comprised 27 corporate and government health care purchasers.
  • Sixteen health plans reported 1992 data on six clinical indicators as part of MHPG's "Cost/Quality Challenge."

Purpose of the Study:

  • To assess health plan performance on key clinical indicators.
  • To evaluate the utility of a purchaser/plan initiative for quality improvement.

Main Methods:

  • Utilized uniform data specifications from a pilot effort for data collection.
  • Defined a "clinically significant average range" for performance comparison.
  • Summarized and reported health plan performance on six clinical indicators in March 1994.

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Main Results:

  • Each health plan exhibited unique performance variations across the six indicators.
  • Opportunities for improvement were identified for prenatal care, mammography, and hypertension screening.
  • Most surveyed purchasers found the Cost/Quality Challenge Report useful.

Conclusions:

  • Despite potential challenges like technical issues and data costs, purchaser/plan initiatives can offer valuable insights.
  • The Cost/Quality Challenge successfully promoted quality improvement activities among health plans through targeted interventions.