Quality of Care Project

The purpose of this project is to improve the quality of care being delivered in the NY Metro area.  The current effort is to provide physicians with more comprehensive performance reports based on aggregated data from all NY Metro area health plans.

Current Objective:  Per the Deming philosophy of "You can't manage what you can't measure", performance on HEDIS measures in the areas of asthma prevention, cardiovascular disease, diabetes and depression, will be reported for primary care physicians.  The data is based on patient-level claims data from all NY Metro area health plans. In 2007, this aggregated data will be released to the physicians and to the participating health plans. We expect that physicians will find the reports to be more representative of their practice and thus able to be more readily used for practice improvement than the current approach of receiving different reports from each plan.

Long-term goals: Publicly report data to employers and health care consumers, quality improvement, collaboration among stakeholders and for pay-for-performance.  Ultimately, the long term measure of success is improved health care within the region.

Key Stakeholders:  This project is under the auspices of the New York Business Group on Health as directed by its employer members that health plans should work cooperatively on non-competitive issues and performance measurement.  A task force was convened in 2004 consisting of employers, health plan representatives and IPRO (the Quality Improvement Organization for New York). A Physician’s Advisory Council is being formed. 

Geographic Coverage: New York City (five boroughs), Nassau, Suffolk, Westchester, Rockland and Orange County and northern and central New Jersey.

Progress to Date: A pilot project completed in 2006 focused on Manhattan. Over 800 primary care physicians received individual reports comparing their performance with that of others in the pilot area and local and national benchmarks. An evaluation sent with the reports provided feedback from the physicians to the NYBGH on this initial report.

2007 activities: Patient-level results will be provided to physicians in order to make the reports actionable.  A data verification pilot project will corroborate the aggregated data provided to the physicians against information contained in the medical charts. Emphasis is also being placed on achieving physician understanding and acceptance of the project. Meetings are being conducted with key stakeholders and various physician groups and academic faculty practices.

For more information: contact Marilyn Wolff Diamond at NYBGH at or .