Score card ranks clinics on care

Three of Spokane’s most-used medical clinics held their own against the rest of the state in measures of treatment including breast and cervical cancer screening and diabetes care, a new insurance company report card shows.

Consumers can see for the first time how Rockwood Clinic, Columbia Medical Associates and Physicians Clinic of Spokane stacked up against a dozen other Washington medical groups in the annual Quality Score Card issued by Premera Blue Cross.

Overall, clinics statewide have some work to do in improving care of acute bronchitis, for instance, which was appropriately treated only about 25 percent of the time, on average, the statistics showed. Discerning those needs is the point of the annual report card, which tracks a dozen treatment measures and four patient satisfaction measures.

“It helps hold us accountable,” said Shelly Smith, director for quality for Premera, one of Washington’s largest insurers. “It’s all about improvement.”

Local clinics met or exceeded scores posted across the state for vital markers that include mammogram and cervical cancer screening and testing of blood glucose, cholesterol and high blood pressure for diabetics. And most patients gave the groups high marks for having friendly office staff, but middling scores for long office waits.

The new scores issued this week indicated that improvement is needed in a few areas. Columbia and Rockwood scored lower than other clinics at providing “well child” checks. And Physicians Clinic of Spokane posted an apparent low mark in treating ear infections.

Representatives from the clinics attributed those scores to errors in reporting. At Columbia, well child visits were billed under the wrong code, resulting in an apparent 30 percent compliance with a requirement to see healthy kids six times in their first 15 months.

“We’re not pooh-poohing the results,” said Valeri Steigerwald, the chief executive of the clinic, who said she supports the score card project.

“We just kind of blew how we billed for our well child visits.”

The situation was similar at Rockwood, which met well child benchmarks 54 percent of the time, said Dr. Rob Benedetti, medical director.

Physicians Clinic doesn’t treat pediatric patients, which resulted in low scores for ear infection care, said Brian Seppi, the clinic’s medical director.

Seppi, who’s also president of the Spokane County Medical Society, said he supports the annual score card, which allows patients to evaluate medical care.

“I think we all need to be benchmarked against others in the state,” he said.

But Benedetti cautioned that the report cards shouldn’t be regarded as absolute measures, especially markers based on information submitted from insurance claims.

He puts most faith in the data clinics report themselves, such as the diabetes care data. By that measure, Rockwood excels.

“As a consumer, I take it with a grain of salt in terms of its claims data, and it reflects some inaccuracies that are inherent in claims data,” he said.

Publishing report cards of clinic care is one element of evidence-based medicine, which seeks to increase transparency and accountability.

The Robert Wood Johnson Foundation announced this week it will finance a study through the University of Washington to measure how quality improvement efforts such as Premera’s affect patient care.

The UW study, led by Douglas Conrad, a professor specializing in health care economics, will study the relationship among between cost and care and quality incentives.

Conrad will compare data from Quality Score Card clinics to those without quality incentives and with a control group of non QSC clinics.