Measuring Medical Group-Level Performance - Consumer Assessment Survey (CAS)

Problem: For many consumers, the most important choice they make is not their health plan, but the selection of a physician and medical group. Historically, redundancy and confusion existed in the California marketplace because individual health plans and provider organizations fielded different surveys of the same medical groups to assess member experience with receiving care. With overlapping provider group networks, these competing efforts wasted limited health care dollars and valuable time. They create confusion for physicians and consumers who are left to make sense of conflicting performance scores.

Impact: This effort provides a tool for medical groups to benchmark their performance against peers and helps provide important choice information to PBGH member company employees, retirees and their families as well as all Californians. The survey results also enable health plans to monitor the quality of care delivered by their network providers, and it is a core element used to determine quality-based performance payments to provider groups through the Pay for Performance initiative. At the physician organization level, it is a critical tool for quality improvement. Through this effort, plus the work underway in Phase 2 of the Provider Group Oversight Improvement Project and Pay for Performance, PBGH is helping create a standard in California and nationally, to reduce redundancy and promote common metrics that will encourage better "apples to apples" comparisons of medical groups.

Current Activities: In August 2003, annual CAS results were reported to PBGH members and to participating health plans and physician organizations. They’re also scheduled for publication on the PBGH HealthScope Web site, as well as through the CCHRI Report on Quality and Web site. The results will also be posted on the Web site of the California Office of the Patient Advocate HMO Report Card in the fall of 2003. Participating medical groups will use the results for quality improvement activities; health plans will use them to recognize and reward medical groups that demonstrate top performance. The survey includes information on 131 California provider groups, representing nearly 78% of the total commercial HMO enrollment in California. Beginning in 2004, six major health plans in California will participate in the Pay for Performance Initiative of the Integrated Healthcare Association. The program will financially reward medical groups for their performance on CAS, six clinical quality indicators and information technology investment focused on the delivery of quality care.

The 2002 CAS results are currently available on the State of California's Office of the Patient California HMO Report Card Web site and on HealthScope.

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Participating Medical Groups, 2003 Survey.

Adobe Acrobat version of 2003 Consumer Assessment Survey.

Note: To obtain a Microsoft Word version of the survey, send an email to info@pbgh.org.

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