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New California ‘report card’ compares health cost and quality

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California consumers can now compare cost and quality ratings for more than 150 medical groups and independent practice associations (IPAs).

The Medical Group Report Card for commercial health maintenance organization members is a four-star rating system and a  result of a partnership between the California Office of the Patient Advocate and the Integrated Healthcare Association (IHA), which represents more than 200 physician groups and the largest health insurers in the Golden State.

Medscape reported that “The IHA has published a comparative report card on groups that participate in managed care plans for about 12 years. The participating health plans began to measure and risk-adjust the total cost of care for each group in 2011. They started reporting to IHA on the groups’ total cost of care in 2014, and those results are included in the report card announced this week.”

“The total cost of care consists of all member healthcare costs, both insured and out of pocket, excluding mental health, substance abuse, vision, and dental costs, Jeffrey Rideout, MD, president and chief executive officer of IHA, told Medscape. So if a patient is linked to a physician in a particular medical group, all the downstream costs associated with that patient’s care are used in computing the group’s cost score.”


Guidance for physicians on staying independent

 

Medical Economics, in its series “Fight Back,” aimed at helping independent physicians and physician groups survive, gives these words of guidance from experts:

The piece says: “So are independent practitioners doomed? If you own a practice, should you take the next buy-out offer from your local hospital system? Not at all. In fact, practices all over the country are finding ways to survive, and even thrive, amid the changes roiling the medical industry.”

Advice:

  • “Accept that electronic health records (EHRs) are necessary to function in today’s healthcare environment and use them to improve patient care by, for example, tracking whether patients have gotten screenings or tests you have recommended previously.
  • “Look for ways to differentiate your practice in the eyes of payers in terms of the services you provide, or your efficiency and outcomes.
  • “Make population health management part of your care (and business) strategy by developing patient registries and tracking quality data.
  • “Embrace government reporting mandates and use them as opportunities to see where you can improve patient care.

“Achieving many of these goals requires more heft, in terms of patient numbers and financial clout, than most small practices can muster by themselves. {Thus} staying independent likely requires teaming up with other independent practices through vehicles such as Accountable Care Organizations (ACOs) and Independent Practice Associations (IPAs).”


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