Premera Quality Program Is One Of Two In U.S. Selected To Study Impact Of Health Insurer Programs On Patient Health And Cost

Premera Announces 2007 Quality Score Card And Quality Awards

October 28, 2007

Contact:

Mark W. Stuart 425.918.3297

MOUNTLAKE TERRACE, WA – After a six-year collaboration with statewide physicians and clinics, Premera Blue Cross' healthcare quality improvement programs will be the focus of a major independent academic study to evaluate the impact of quality programs on the healthcare delivered by Washington physicians and clinics.

The study, funded by the Robert Wood Johnson (RWJ) Foundation's Changes in Health Care Financing and Organization (HCFO) Initiative, will be conducted by Douglas Conrad, Ph.D., a University of Washington professor specializing in health services economics, and his UW colleagues David Grembowski, Ph.D., Diane Martin, Ph.D., and Chuck Maynard, Ph.D. The UW study will examine the relationship between quality and cost impacts of quality incentives by examining clinical quality and efficiency in caring for a broad array of patients. Dr. Conrad will compare data from the Quality Score Card (QSC) program clinics that had quality incentives with ones without.  Those clinics will then be compared with a control group of non-QSC clinics whose performance was scored by Premera outside of the program.

"The variety and longevity of Premera's quality initiatives are unique in this region and rare nationally. That made it very attractive to me and to RWJ for studying quality programs as a microcosm," said Dr. Conrad.  "This study has the potential for significant impact on how we approach delivery of health care."

"Premera's collaborative approach to quality improvement places it in the vanguard of today's quality assessment programs. They not only measure process, but examine outcomes.  By including data on electronic capability and generic usage, we will be able to examine also the relationship of quality and outcomes with costs and efficiency.  Through Premera's recognition and financial incentives for their clinics' community quality activities, I believe communities served by these clinics may have benefited already," said Dr. Conrad. 

Premera has expanded its quality initiatives beyond this.  In 2005, it began expanding its quality programs to all sizes of clinics and practices throughout Washington.  Premera now produces quality reports for 217 groups and annually recognizes the highest performing practices of all sizes in Washington state (see below).  Using these reports, the company is in the process of consulting with 60 practices on quality improvement.

Confidential, Patient-specific, Actionable Information for Physicians
Premera's next step is to move beyond annual scorecards and begin to provide confidential, patient-specific, actionable information on a large scale to physicians who want to support more effective preventive care. Premera has done so with selected medical groups for several years. In 2007, Premera accelerated its efforts through a collaboration with the Washington State Medical Association (WSMA) Educational and Research Foundation (WSMERF) to launch its statewide Quality Improvement Program. The "Quip" will provide primary care physicians with actionable data specific to individual patients. Premera worked with WSMERF to develop a way to ensure the information protects patient confidentiality.

"Beyond data, Premera provided us with expertise and insight that only an organization with a longtime commitment to quality and true collaboration with physicians could deliver," said Tom Curry, WSMA executive director.  "Their innovative contributions gave our program the tangible support that demonstrates how physicians and health plans can work together."

Support for Hospital Quality and Safety
Premera also became the first health plan to join the Washington State Hospital Association's [Patient Safety Initiative]. Premera is supporting WSHA programs to accelerate the adoption of best practices to reduce medical errors. 

"Washington hospitals' strong focus on patient safety dovetails perfectly with Premera's interests.  We are very grateful for Premera's participation in the future of patient safety in Washington State's hospitals," said Leo Greenawalt, president of the WSHA.

Support for Community-wide Health Care Performance Measurement
Premera also has been a strong supporter of community-based quality improvement via the Puget Sound Health Alliance, a non-profit coalition of employers, doctors, hospitals, unions, consumer groups and health plans. The Alliance has received national attention for its progress in developing a community-based health care performance report involving many organizations.

"Premera's leadership and experience have been key ingredients," said Margaret Stanley, Puget Sound Health Alliance Executive Director.  "We've had the great fortune to be able to build on the track-record of trust created by Premera and many major medical groups in their multi-year collaboration to create Premera's Quality Score Card."

Premera has joined 13 other health plans, self-insured employers and union trusts, supplying data for the Alliance's first report, which will measure effective care provided by medical clinics in the Puget Sound region. The Alliance aims to provide a broad array of comparative reporting to help all stakeholders make informed decisions to promote, choose and reward more effective and affordable health care. 

2007 Quality Score Card Results: Are we turning the corner?
This year, as Premera staff began assessing the newest data and comparing to its previous data, they believe they may be seeing what could be early signs that Washington may be beginning to turn the corner on health decline.

"It's still too early to say for sure, but key indicators are moving in the right direction," says Dr. Mark Sollek, Medical Director at Premera Blue Cross who led development of the Quality Score Card. "Credit goes to Washington physicians who are delivering measurably improved health care quality, and to consumers who are beginning to heed the call for healthier lifestyles."

The following measures are the indicators that have piqued the analysts' interest and have stimulated the question of a possible turning point in Washington health care:

 Blood pressure control among diabetics has improved for three consecutive years.
 Use of drugs that protect kidneys and blood vessels among diabetics is up by 21 percent since 2005 in the QSC clinics
 Long-term blood sugar screening rates for diabetics have improved three percent this year, and 12 percent over the past three years.
 Cholesterol screening rates for people with diabetes and heart disease and are up four percent and eight percent, respectively, since 2006.

For details of this year's data go to: www.premera.com/qsc.  The site (and the links in this news release) goes live on November 1.

Quality Score Card Medical Groups
The number of medical groups in Washington has increased from six to fifteen.  This collaboration has involved many projects at each medical group. 

For news on their projects and contacts, click on the clinic names.

Columbia Medical Associates (Spokane)
Lakeshore Clinic (Kirkland)
Madrona Medical Group (Bellingham) 
Minor & James Medical (Seattle)
MultiCare Medical Group (Tacoma)
Pacific Medical Centers (Seattle)
Pediatric Associates (King County)
Physicians Clinic of Spokane
Rockwood Clinic (Spokane)
Swedish Physicians (Seattle)
The Everett Clinic
The Polyclinic (Seattle)
University of Washington Medicine
 Neighborhood Clinics (Seattle)
Virginia Mason Medical Center (Seattle)
Wenatchee Valley Medical Center
 

Quality Award Program (QAP)
Premera is honoring this year 27 practices across Washington for promoting healthcare quality and representing best practices in the delivery of high quality care to patients.  They were selected from the 778 practices assessed across Washington.  Although the initial year (2005) used a subset of Quality Score Card measures, these measures have since been categorized into four “Care Indices” categories: Acute, Chronic, Preventive, and Overall Quality.  For more detail on the categories and to see the list of honorees, click here. 

About Premera Blue Cross
Our mission is to provide peace of mind to our members about their healthcare coverage. We provide health care coverage and related services to more than 1.3 million people. Premera Blue Cross has operated in Washington since 1933 and Alaska since 1952. Premera Blue Cross is an independent licensee of the Blue Cross Blue Shield Association.
Premera Blue Cross is a member of a family of companies headquartered in Mountlake Terrace, Washington, that provide health, life, vision, dental, and long-term care insurance, and other related services.  In the J. D. Power and Associates 2007 National Health Insurance Plan Satisfaction StudySM, Premera Blue Cross achieved the “highest member satisfaction with commercial health plans” (regional and national companies) serving the western U.S.  2007 is the inaugural year for this study.