title: Reporting and using health plan performance information in Massachusetts.
abstract: BACKGROUND
  In 1993, 27 corporate and government health care purchasers formed the Massachusetts Healthcare Purchaser Group (MHPG). Sixteen health plans submitted 1992 data on six clinical indicators-mental health inpatient days per patient and inpatient readmission, blood pressure screening, prenatal care, mammography screening, cesarean section (C-section) rates, and asthma admission rates-developed in an earlier pilot effort in response to the quality portion of MHPG's "Cost/Quality Challenge."
  
  
  METHODS
  Detailed data specifications developed in the pilot to ensure uniform data collection were used, with a requested sample size for chart-reviewed measures of 220. A "clinically significant average range" was defined. Health plan performance was summarized for each indicator in a report released in March 1994. REPORTING OF CLINICAL INDICATOR RESULTS: For the six indicators, each plan had a unique pattern of variation from the average range. For prenatal care, mammography, and hypertension, many plans had opportunities for improvement. SURVEY OF PURCHASERS: Most of the purchasers MHPG surveyed in October 1994 about their assessment and use of the Cost/Quality Challenge Report found it useful. RESPONSES TO THE REPORT: To promote quality improvement activities among health plans, MHPG showed purchasers how to pursue performance issues with health plans, held a Best Practice Forum on C-section, and created a follow-up endeavor, the Coordinated Purchasing Initiative.
  
  
  CONCLUSIONS
  In spite of potential problems posed by technical deficiencies, costs of data acquisition and quality efforts, and unintended effects of public reporting, purchaser/plan initiatives such as the Cost/Quality Challenge can provide valuable information to purchasers.
authors.affiliation: Blue Cross Blue Shield of Massachusetts, North Quincy 02171-1794, USA.
authors.forename: H S
authors.initials: HS
authors.lastname: Jordan
authors.forename: J H
authors.initials: JH
authors.lastname: Straus
authors.forename: M H
authors.initials: MH
authors.lastname: Bailit
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D003625:Data Collection; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006279:Health Maintenance Organizations / Q000592:standards*; D006801:Humans; D007255:Information Services; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008404:Massachusetts; D008484:Medicaid / Q000191:economics / Q000592:standards; D008875:Middle Aged; D011247:Pregnancy; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D014481:United States