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Medical Group Quality Care Ratings

About Medical Group Quality

High scoring medical groups see that patients who are at-risk are screened for deadly diseases. These medical groups make sure that doctors are tracking patients with chronic conditions to help them avoid complications or a worsening of their disease. The groups also see that patients, including young children, get vaccines to prevent illness.

Medical group and HMO quality care ratings should not be compared because the information and the performance measures for each differ in a number of ways including:

  • There may be a very different mix of patients whose care is being measured even if both medical groups and HMOs are rating care for the same health condition
  • The standards used to measure performance differ for the medical group and HMO
  • The patient's medical chart is used as an information source for a number of HMO quality measures but the chart is not used for measuring medical group performance
  • The performance topics that are combined to rate medical groups overall differ from those used to rate HMOs
  • The information that is kept by medical groups and HMOs is different; so, the steps to check the quality of each differs

Where to Find More Information

IHA P4P Physician Group Clinical Care Ratings

The Integrated Healthcare Association (IHA) is a California leadership group of health plans, physician groups, and health systems, plus at-large academic, purchaser, pharmaceutical industry, and consumer representatives, involved in policy development and special projects around integrated health care and managed care.

The IHA-sponsored Pay for Performance program generates medical group quality care measures. The program promotes a common set of measures that evaluate clinical quality of care for preventive services - such as breast cancer screening and childhood immunizations - plus treatment of chronic conditions such as diabetes and asthma.

Although medical group quality care data is not collected by the Office of the Patient Advocate, the accuracy of this information is independently checked.