Private "Performance Feedback" Reporting for Physicians

Over the past decade, a growing body of research and online resources has emerged to provide guidance on effective practices for publicly reporting information on provider performance for consumers. These recommendations are for the most part evidence based and assume that an effective report is one that contains performance information that consumers understand and find both credible and relevant. In addition, information is conveyed in a way that makes it as easy as possible for consumers to use it to make good choices among providers. Another key audience for performance reporting is physicians themselves. Health plans and medical groups have sponsored private physician "performance feedback" reports for many years, with the intention of supporting internal quality improvement efforts as well as patient care management. More recently, multistakeholder community quality collaboratives, including roughly half of the Chartered Value Exchanges (CVEs) supported by the Agency for Healthcare Research and Quality (AHRQ), have begun to produce some type of private report for physicians in parallel to their public report for consumers. These groups recognize that a single report designed for one audience cannot meet the needs of both. In addition, the Centers for Medicare & Medicaid Services (CMS) has sponsored pilot studies of the effects of providing individual physicians and medical groups with performance feedback based on claims data and CMS's Physician Quality Reporting System. In contrast with public reports, private reports are often confidential and limited in distribution to those with a "need to know." Thus, little research even of a descriptive nature has been conducted on the various forms that private reporting has taken. Limited discussion of how to define and measure the effectiveness of such reports and little published evaluation research are available. Therefore, the science of private "feedback reporting" for physicians is nascent at best. As CVEs and other community quality collaboratives consider strategies for private feedback reporting to physicians and other health care providers, they will need to address basic issues such as report design and distribution. They also will need to examine their role in relation to existing and planned internal performance reporting activities of the health systems and medical practices in their markets. In contrast to public reporting for consumers, where the role of a neutral, multistakeholder collaborative is relatively well accepted as a source of objective, communitywide performance data, the role of community collaboratives in private feedback reporting is not always so clearly defined. Many health plans and health systems, which may themselves be collaborative members, have developed very sophisticated internal reporting systems of their own based on electronic health records. In the context of these and other private performance reporting initiatives, community collaboratives will need to determine the unique value-added features that their private feedback reports can provide. The goal is to complement rather than compete with reports from their provider members or other report sponsors. This resource document is intended to provide practical information and guidance primarily to CVEs and other community quality collaboratives interested in the design, dissemination, and use of private feedback reports on physician performance.