October 21, 2008
TO: California Physicians
FROM: Joe Dunn, CEO California Medical Association
RE: California Physician Performance Initiative
In the coming days and weeks, more than 20,000 California physicians will receive a letter from the California Cooperative Healthcare Reporting Initiative (CCHRI) [1]. This letter will include a report detailing the physician's "performance score" on a limited set of quality measures for Medicare patients and private PPO patients from Anthem Blue Cross, Blue Shield of California, and United Healthcare.
CCHRI is sending this letter as part of the California Physician Performance Initiative (CPPI), one of six pilot programs in the nation initiated and funded by Medicare in 2007. It is intended to measure and report the quality of health care provided by physicians and to be an educational tool for physicians. The report will provide physicians with a confidential percentile rank compared to their physician peers, performance scores by measure, and performance scores for each patient group (Medicare only, private PPO only, and both Medicare and private PPO combined).
All physician scores will be kept confidential at this point. CMA strongly urges physicians who receive this report to verify the accuracy of the data used to calculate their scores. To do so, physicians should request the private health plan patient lists at the CCHRI website. Requests should be made via the "Physician Comment and Request for Information Period Process [2]."
It is important to note that the Medicare patient lists will not be available to physicians for verification due to strict federal confidentiality and privacy laws. However, this also means that the physician-specific Medicare quality data will not at any time be released to the public by either Medicare or CCHRI, and it will be destroyed upon completion of the CPPI pilot.
While CCHRI does not intend to make these results public and future use of the results by payors is unclear at this point, CMA has serious concerns about CCHRI's long-term plans to make future results public and how payors will use the results. It should be noted that these two issues- public release and use of results- will not be determined until CCHRI's Steering Committee has received feedback from physicians and CMA. Therefore, it is absolutely critical that all physicians verify the accuracy of the data used to calculate their scores by logging on the CCHRI website mentioned above.
As an organization of care givers, we support quality initiatives aimed at improving care for patients, but they must be fair, credible, and reasonable. To this end, CMA continues to work aggressively with CCHRI by ensuring active involvement from CMA physicians in the CPPI project, requiring CCHRI to provide physicians a reconsideration process (i.e., "Physician Comment and Request for Information Period Process [2]"), and communicating with Medical Executive Committees about the status of the CPPI project.
Joe Dunn
CEO, California Medical Association