Patient Safety Monitor Journal, a premiere magazine focused on cutting edge best practices in patient safety, recently profiled MPIRICA in a piece titled “Surgeon ratings websites aim to make a mark on patient care.”
The article sets the tone with a bit of history, in which ProPublica, a non-profit news organization, seemed to lead the charge around healthcare quality transparency with their “Surgeon Scorecard” in July 2015.
However, its methodologies quickly came into question. Critics believed the scorecards were based on “unreliable data points to rate surgeons’ complication rates,” and failed “to account for the many factors that can alter a patient’s outcome.”
Shortly after the ProPublica release, MPIRICA launched surgeon quality scores, which had been in development for several months and were modeled similarly to our hospital quality scores released earlier in 2015. Both are distinctly different from that of ProPublica’s because we incorporated “a risk adjustment model that’s been utilized by experts… for nearly 30 years.”
The MPIRICA Quality Score methodology considers variation in patient risk factors when scoringperformance. For example, surgeons and hospital systems that take care of sicker patients will naturally see higher complication rates, and the risk adjusted model accounts for this variation and levels the playing field across the healthcare spectrum. The original methodology was developed by a team of clinicians and statisticians who have “been working with hospitals, clinicians, and insurance companies to refine healthcare quality measurement and risk adjustment methodology since 1988.”
To be fair, as the article states, “ProPublica incorporated adjustments identified by a panel of surgeons.” However, we would “argue [that our] risk adjusted model is more accurate and complete, and could serve to improve the quality of surgical care.”
Patient Safety Monitor Journal did a great job highlighting MPIRICA’s specific methodological approach. Namely that MPIRICA takes clinical records and focuses on objective outcomes. The risk model then calculates a predicted value for each patient group and compares that to the observed values to see where the performance of the surgeon differ.
Such a rating system can be beneficial to the quality of care going forward. MPIRICA envisions improvement in the way consumers choose providers based on quality. “Steering employees toward surgeons and hospitals with higher quality ratings can save thousands of dollars in healthcare costs” per incidence of care. And the models can be improved over time with the addition of quality data from hospitals and health systems. In fact, “Proliance Surgeons, one of the largest surgical practices in the country with 200 board-certified physicians providing care in Washington state, agreed to partner with MPIRICA earlier this year. Proliance will hand over its quality data so MPIRICA can perform quality rankings on ambulatory procedures and inpatient procedures that are not included in Medicare’s data.”
“‘That’s how impressed we are with them,’ says Bill Fletcher, a clinical outcomes analyst at Proliance Surgeons. ‘I’m actually willing to give them the data.’ Fletcher notes that he was significantly less impressed with ProPublica’s model, but felt MPIRICA had a much more rigorous model.”
The article concluded by noting that although surgeon rating systems are starting to impact the consumer marketplace, there are still challenges ahead. Most of the available scoring systems include subjective reviews, and of the ones that are based solely on outcomes data, many contains fewer than 15 procedures. ProPublica’s Surgeon Scorecard covers only 8 procedures, whereas Consumers’ Checkbook’s Surgeon Ratings offers “14 procedures, and does not include scores for lower-than average surgeons.”
By contrast, MPRICA has been covering 64 inpatient procedures, and will release more than 1,000 outpatient procedures shortly. While these scores are currently not publically available, any employer can sign up to provide employees with access to the scores for little to no cost.
We understand that ultimately having the right methodology, a focus on objective outcomes data, and broad coverage is how we make a mark on patient care. We’re glad to have the recognition from Patient Safety Monitor Journal for the work we have been doing towards that goal..