State gets 'F' for lack of public info on medical care

Connecticut is one of 41 states to earn a failing grade from health advocates for lacking public information about the quality of care provided by doctors.

"Consumers should be able to find out if their local primary care physician is delivering good quality care without having to go through hoops," said Francois de Brantes, executive director of the Health Care Incentives Improvement Institute in Newtown, which published the report. "Connecticut has no public reporting of physician quality."

The "State Report Card on Transparency of Physician Quality Information" scored states on many factors, including the number of doctors rated, whether the ratings included information about clinical outcomes and consumer experiences, and how easy it was to access information online.

Only two states, Minnesota and Washington, received an "A." California received a "C," and the remaining states earned a "D" or "F."

Mark Schaefer, Connecticut's new director of health care innovation, wasn't surprised.

"It's widely recognized that consumers in the health-care market don't have accessible and reliable information about the cost of treatments across settings and the quality of providers at the clinical level," he said. "Like most states, this is something Connecticut is working on."

Having access to transparent information about provider quality and costs has become increasingly important as consumers facing higher insurance deductibles and out-of-pocket expenses try to make informed decisions when comparing physician networks and health plans.

Comparing the performance of providers can be more challenging than comparing price because it's so subjective, said Dr. Robin Oshman, president of the Fairfield County Medical Association, which represents about 2,000 doctors in the region.

"How do you define quality?" said Oshman, a dermatologist practicing in Westport. "It's very hard to do."

She said performance databases can be tricky to navigate for that reason, and she compared them to using the Yellow Pages to find a doctor.

Matthew Katz, executive vice president and chief executive officer for the Connecticut State Medical Society, echoed her sentiments.

"What constitutes as quality for one insurer, provider or consumer may be completely different for another," he said.

Many current sources of physician performance data from the federal government, commercial insurers and nonprofit organizations are often "inconsistent, incomplete, invalid and inaccurate," offering only a "small snapshot" of a doctor's entire practice, Katz said.

"You can't just throw numbers out there without explaining the criteria used to determine quality and providing a road map for improvement," he said. "Data presented in isolation doesn't provide a true and accurate picture of the care being provided."

Nationwide, states with passing grades on performance transparency had state-specific initiatives with insurers, providers and consumers developing a universal system of identifying and recording data and defining quality.

Changes underway nationally and statewide bode well for consumers. To start, Medicare officials plan to release data on physician quality collected by the federal government later this year, according to de Brantes.

In Connecticut, health experts expect a number of reform efforts to play important roles in establishing performance, quality and cost transparency. That includes the all-payer claims database currently under construction as part of federal health care reform legislation.

Access Health CT, the state's health insurance exchange, has received a federal grant to help construct the large-scale database would collect medical, dental and pharmacy claims from commercial insurers and public insurers such as Medicare and Medicaid. Consumers will have access to the data in a free web-based portal.

Last week, the Connecticut Hospital Association took another step toward greater price transparency when it recommended that members take steps by March 1 to inform patients about facility fees if they receive care at hospital-owned medical offices.

A new state law requiring health-care professionals who provide direct patient care to wear identification badges with their credentials is a positive step toward transparency, Katz said.

"Truth in advertising is part of quality," he said. "Consumers need to understand a provider's scope of practice to know if he or she can provide the services they truly need."

Performance transparency is a major element of the Connecticut Healthcare Innovation Plan submitted to federal officials in December, said Schaefer, who is leading the state initiative. The plan calls for the creation of a common performance scorecard for providers beginning with primary care physicians.

Providers would be accountable for the quality and cost of care and, in some cases, benefit from savings.

Staff writer Amanda Cuda contributed to this report.