Today's health care environment is complex and ever-changing. Finding quality health care for yourself or your loved ones is often a primary -- and sometimes puzzling -- concern. Medica is committed to supporting our members by providing a variety of resources, including easy-to-use reports on the quality of care provided by physicians, primary care clinics and hospitals. Our goal is to provide you with helpful information so that you may make sound health care choices for yourself and your family.
The information provided here comes from multiple sources and is organized by these five categories:
Physician
HowWasYourCare.com - This online survey allows you to rate the service and care your physician provides and to see ratings for your own and other physicians. Completing the survey will help your physicians learn what they’re doing well and what they can do to improve.
Recognized Physician Directory - This directory identifies physicians who have been "recognized" for performing well in diabetes and heart/stroke programs created by the National Committee for Quality Assurance (NCQA). NCQA established the diabetes program and heart/stroke program to identify physicians that meet standards of care.
Licensing/Sanction Information - This link provides the licensing background and disciplinary information of physicians and other health care practitioners using the Administrators in Medicine's (AIM) DocFinder feature.
American Medical Association (AMA) DoctorFinder for Patients - This link provides professional information about virtually every licensed physician in the United States and its possessions- including more than 690,000 doctors of medicine and doctors of osteopathy or osteopathic medicine.
Clinic
- Primary Care clinic quality reviews are conducted annually by Medica’s registered nurses who have years of experience in health care quality improvement programs. The reviews focus on some of the most common health care issues facing our community today. Results of these reviews are broken out for you based on the type of health plan you have with Medica.
Quality review results are reported by clinic system. Clinic systems are chosen for these programs based on the number of Medica members they serve and the member population matching review criteria. Only those clinic systems that participated in our 2007 review programs and had a review sample size of 30 or more per measure are included in this publication.
To view clinic system results and definitions, click on the Clinic Results link.
Medica's Commercial Quality Improvement (CQI): This program provides information about the quality of care given to members who receive health coverage through their employers.
Clinic Results: Childhood Asthma, Chlamydia Screening, Colorectal Cancer Screening, Alcohol Use Assessment, Depression Assessment
Medica's Choice Care Quality Improvement Program (CCQIP): This program provides information about the quality of care given to Medica ChoiceCare and Medica MinnesotaCare members.
Clinic Results: Adult Diabetes, Childhood Asthma, Cancer Screening, Child & Teen Checkup and Chlamydia Screening
Medica's Medicare Quality Improvement Program (MQIP): This program provides information about the quality of care given to Medicare members.
Clinic Results: Diabetes, Advance Directive, Colorectal Cancer Screening, Breast Cancer Screening, Alcohol Use Assessment, Depression Assessment
Medica's General Chart Review Program (GCR): This program provides information about the quality of care given to a combined group of Medica members. Results include measurement of care for Commercial, Choice Care and Medicare members.
Clinic Results: Problem List, Medication Safety, Immunizations
High Performing Clinics: Each year, Medica recognizes clinic groups that stand out among their peers in specific areas of care. The following articles were published in Medica’s “Connections” Newsletter. This newsletter is a monthly publication for providers in the Medica Network.
Advance Directive
Chlamydia Screening
Childhood Asthma
Child & Teen Checkups
Minnesota Community Measurement - Minnesota Community Measurement is an extraordinary health care initiative that makes useful information available to physicians and patients, and communicates findings in a fair, usable and reliable way. This nonprofit organization is dedicated to improving patient care in Minnesota.
Medica uses the Minnesota Community Measurement diabetes results to financially reward medical groups. For more information, visit Medica’s Performance-Based Incentive Programs, a complete inventory of all the measures Medica uses to evaluate and reward medical groups.
Compare YourCare (CYC) - This interactive Web site is designed to help consumers understand what constitues quality health care and how they can get it. You can use the tool to find out if your doctor is performing the recommended tests and treatments for your condition; learn what questions to ask a doctor; and discover what can be done to improve your care.
Hospitals
The LeapFrog Group - Hospitals report their progress on having four recommended patient safety practices in place. This report is provided by a national coalition comprised of public and private organizations called The Leapfrog Group. This group selected these practices for reporting because they have been found to prevent medical mistakes or poor medical outcomes and are described below. To view the hospital data for your state click on the Hospital Safety Results Report.
Hospital Safety Results Report
- Computer Physician Order Entry (CPOE): This is a computerized system used by physicians to order and track medications in an effort to avoid errors that can happen when handwritten instructions are misread. These systems can also warn physicians about possible drug interactions, allergies or overdose. CPOE has been shown to reduce serious prescription errors in hospitals by more than 50%.
- Evidence Based Hospital Referral (EHR): Patients with high-risk conditions who go to hospitals that frequently perform these high-risk treatments or procedures have the best chance of surviving and successfully recovering. The EHR measure displays data on hospitals' annual experience with seven specific high-risk conditions.
- Intensive Care Unit Physician Staffing (IPS): According to LeapFrog, there is evidence of a direct link between the level of training of ICU personnel and the quality of patient care. Hospitals fulfilling this measure assure that all patients in their adult general medical and surgical ICUs are managed or co-managed by physicians certified (or eligible for certification) in critical care medicine. Staffing ICUs with physicians who have credentials in critical care medicine has been shown to reduce the risk of patients dying in the ICU by more than 10%. (The LeapFrog Group Fact Sheet is available at www.leapfroggroup.org)
- Leapfrog Quality Index: This measures the degree to which a hospital has adopted 27 of the National Quality Forum Safe Practices.
Adverse Health Events Report - Area hospitals are now required to report to the Minnesota Department of Health whenever any of 27 identified preventable adverse events occur. This first of its kind report includes information about the number and type of events that occurred between July 2003 and October 2004.
Minnesota Hospital Quality Report - This site gives you a snapshot of hospitals' performance in three key areas: Heart Attack, Heart Failure and Pneumonia. With the tools provided on this site, you can quickly see how often a particular Minnesota hospital provides the care that is expected for these conditions. You can also compare how different hospitals perform.
Hospital Compare - A quality tool for adults, including people with Medicare. This tool provides you with information on how well the hospitals in your area care for all of their adult patients with certain medical conditions. Information provided on this Web site will help you compare the quality of care hospitals provide. Hospital Compare was created through the efforts of the Centers for Medicare and Medicaid Services (CMS) and organizations that represent hospitals, doctors, employers, accrediting organizations, other federal agencies and the public.
Quality Check - This is a source of accreditation and comparison information that you can use to determine whether a health care organization might meet your needs. The information found on this Web site is provided by the Joint Commission on Accreditation of Healthcare Organizations.
Nursing Homes
Nursing Home Report Card - This nursing home report is provided by the Minnesota Department of Health and the Minnesota Department of Human Services. The purpose of this report is to provide information that might help you to make a choice on a nursing home for yourself, a family member or other loved one. In addition to this site, you should also consider other sources of information, visit the nursing homes being considered, and discuss your choices with family and staff members of each facility.
Additional Resources
The Institute for Clinical Systems Improvement (ICSI),a collaboration of Minnesota-based health care organizations and providers, writes consumer-friendly guidelines for care. They are focused on helping providers identify and incorporate best clinical practices for their patients.
Main Street Medica: Understanding the cost variations that exist among providers can help you make more informed, cost-conscious choices about your care. Use our cost and quality resources at Main Street Medica to see cost comparisons for a variety of common procedures and conditions at Minnesota facilities and primary care clinics. The comparisons are based on Medica Choice® network contract rates. Note: Members with access to myMedica.com can log on to view even more detailed cost information.