About The Data
About the Performance Reports
KCQIC works with providers to produce Primary Care Practice Performance Reports, providing data on the quality of care provided by primary care physician groups in the greater Kansas City area.
The measures used in this report were selected by the KCQIC community collaborative and are nationally approved measures of quality care. The report shows how often patients get effective care or care that the medical community agrees works best to promote better health for chronic conditions such as diabetes, asthma, depression and heart disease.
Measuring practice performance is complex. Much of the performance data is derived from medical claims, which have limitations for measuring quality, since not all aspects of care are included; there is no billing, procedure, or diagnosis code for certain health services or problems, so some information does not appear in claims. In addition, the data is not always recent. While everyone would prefer to show very recent data, there will always be lag time when using claims data due to the steps involved in billing and payment, and time to combine information and determine the results. While not all medical care shows up in billings data, the data does include valuable information about diagnoses and whether services such as cholesterol tests were provided.
In order to be able to provide health care quality information, health plan claims (billing) data is currently the only high-volume data available in electronic format for most primary care physicians in the community. Health plan claims data reflects information that practices submit as part of the billing process.
Claims data may include errors due to how care is coded and billed. In addition, some information that would exclude patients from the denominator in a particular measure for clinical reasons are not always available. For example, women who have had a hysterectomy with no residual cervix do not need pap smears and yet were likely included in the denominator for the measure. We estimate this lowers the measured cervical cancer screening performance. Patients may also be mislabeled with a diagnosis due to coding even if they do not have that disease. For instance, a patient that receives a blood sugar test could be mislabeled as being diabetic even if the test results are normal. These mislabeled patients could then be in the denominator for each of the diabetes measures. With claims data, there are limited opportunities to confirm, deny, or quantify the impact of these types of errors. Because NCQA data are based on health plan results, they are not directly comparable to physician or medical-group level results. For example, plan level HEDIS specifications define measure denominators from the plan’s eligible population, which may differ from definitions of the medical group’s eligible population. Plans are accountable for all enrollees; medical groups may be accountable only for those who have had a visit with the medical group one or more times. Although direct statistical comparison is not appropriate, health plan HEDIS results may be the best comparative information available to Alliances at this time. The information can be used to aid interpretation of the results with full disclosure of methodological differences.
Information for the 2008 report was provided by six commercial health plans, including two managed Medicaid health plans.
The 2009 and 2010 data were provided by Kansas City health plan partners including Blue Cross Blue Shield of Kansas City, CIGNA, Coventry, Humana, and United Healthcare. This information is based on claims received from primary care physician offices. These claims were for HMO (Health Maintenance Organization) patients only and did not include patients with Medicare, Medicaid or other health plans.
The 2011 and 2012 data included HMO and PPO (Preferred Provided Organization) plan data provided by Blue Cross Blue Shield of Kansas City, CIGNA, Coventry and Humana. The data did not include information from Medicaid or Medicare. Patients were assigned administratively to a specific primary care provider based on the majority of visits in the reportable period.
Every primary care practice in the Kansas City region may not be listed in the report. Some practices may only be listed under certain measures. This is because there were not enough patients from that practice for statistical significance for that measure.
Primary Care Physician (PCP) practices were asked to review their results, confirm doctors in the practice and the location of the practice before the data was put on this website. Not all practices reviewed or confirmed their information, so some of this information may be incorrect.