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Physicians and Facilities

Quality Resources

Finding quality health care for yourself or your loved ones is often a primary — and sometimes puzzling — concern. Medica is committed to supporting our members by providing a variety of resources, including easy-to-use reports on the quality of care provided by physicians, primary care clinics and hospitals. Our goal is to provide you with helpful information so that you can make sound health care choices for yourself and your family.

The information provided here comes from multiple sources and is organized into six categories:

Physician Quality This online survey allows you to rate the service and care your physician provides and to see ratings for your own and other physicians. Completing the survey will help your physicians learn what they’re doing well and what they can do to improve.

Recognized Physician Directory: This directory identifies physicians who have been "recognized" for performing well in diabetes, heart/stroke and back pain programs created by the National Committee for Quality Assurance (NCQA). NCQA established these programs to identify physicians that meet standards of care.

Licensing/Sanction Information: This link provides the licensing background and disciplinary information of physicians and other health care practitioners in the Administrators in Medicine's (AIM) DocFinder.

American Medical Association (AMA) DoctorFinder for Patients: This link provides professional information about virtually every licensed physician in the United States.

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Clinic Quality

Medica Quality Review Programs

Primary Care clinic quality reviews are conducted annually by Medica's registered nurses who are experienced in health care quality improvement measures. The reviews focus on some of the most common health care issues facing our community today.

Quality results are reported by clinic system. Clinic systems are chosen for these programs based on the number of Medica members they serve and the member population matching the review criteria. Only those clinic systems that participated on our 2012 review program and had a review sample size of 30 or more per measure are included in this publication.

View clinic system results and definitions »

  • Pediatric and Young Adult: Provides information about the quality of care given to child and young adult members, age 0-20 years.
    Clinic Results: Complete Child and Teen Checkup (only for Minnesota Health Care Programs).
  • Adult Health Promotion: Provides information about the quality of care given to adult members, age 19-80 years.
    Clinic Results: Depression Assessment and Advance Directives.
  • General Chart Documentation: Provides information about general medical record documentation.
    Clinic Results: Problem List and Medication List.

MN Community Measurement: MN Community Measurement is a collaborative effort among care providers, health plans, employers and other stakeholders to provide greater transparency in the health care system.

Performance-Based Incentive Programs: A complete inventory of all the measures Medica uses to evaluate and reward medical groups. Medica uses the Minnesota Community Measurement diabetes results to financially reward medical groups.

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Hospital Quality

The Leapfrog Group: Hospitals report their progress on having four recommended patient safety practices in place. This report is provided by a national coalition comprised of public and private organizations called The Leapfrog Group. This group selected these practices for reporting because they have been found to prevent medical mistakes or poor medical outcomes and are described below.

Leapfrog Hospital Safety Ratings:

  • Computerized Physician Order Entry (CPOE): This is a computerized system used by physicians to order and track medications in an effort to avoid errors that can happen when handwritten instructions are misread. These systems can also warn physicians about possible drug interactions, allergies or overdose. CPOE has been shown to reduce serious prescription errors in hospitals by more than 50%.
  • Evidence Based Hospital Referral (EHR): Patients with high-risk conditions who go to hospitals that frequently perform these high-risk treatments or procedures have the best chance of surviving and successfully recovering.
  • Intensive Care Unit Physician Staffing (IPS): According to Leapfrog, there is evidence of a direct link between the level of training of ICU personnel and the quality of patient care. Hospitals fulfilling this measure ensure that all patients in their adult general medical and surgical ICUs are managed or co-managed by physicians certified (or eligible for certification) in critical care medicine. Staffing ICUs with physicians who have credentials in critical care medicine has been shown to reduce the risk of patients dying in the ICU by more than 10%.
  • Leapfrog Safe Practices Score: This measures the degree to which a hospital has adopted 27 of the National Quality Forum Safe Practices.

Adverse Health Events Report: Area hospitals are required to report to the Minnesota Department of Health whenever any of 28 identified preventable adverse events occur.

Minnesota Hospital Quality Report: This site gives you a snapshot of hospitals' performance in five key areas: heart attack, heart failure, pneumonia, infection prevention and surgical care. The site also lets you see how patients rated their hospital care in a variety of areas and whether they would recommend the hospital to others.

Hospital Compare: This tool allows you to compare hospitals based on the quality of their care (for example, do they give recommended treatments known to get the best results for certain conditions). You can also get patient survey results, as well as compare rates of readmission, mortality rates and more. Hospital Compare was created through the efforts of the Centers for Medicare and Medicaid Services (CMS) along with the Hospital Quality Alliance.

Quality Check: This site lets you see whether a health care organization has been accredited or certified by the Joint Commission, a reflection of an organization's commitment to meeting certain performance standards.

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Nursing Home Quality

Nursing Home Report Card: This nursing home report is provided by the Minnesota Department of Health and the Minnesota Department of Human Services. The report provides information that can be helpful when evaluating a nursing home for yourself, a family member or other loved one.

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Conditions and Treatments

Clinical Performance Measures Report: This report, prepared annually by Medica, gives you a way to look at clinical care quality for many common conditions and treatments.

Medica measures clinical care quality in several ways. To measure quality by condition, we collect data from clinics and care systems throughout the Medica network. By tracking the performance over time, we can measure our network's progress toward achieving best clinical practices.

This report shows the results from two key measurement tools: HEDIS (Healthcare Effectiveness Data and Information Set) and C&SQR (Clinical and Service Quality Review).

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Additional Resources

Medica’s Quality Improvement Program: Overview of the purpose, scope and activities that make up the Medica Quality Improvement Program.

Institute for Clinical Systems Improvement (ICSI): This collaboration of Minnesota-based health care organizations and providers champions health care quality and value. ICSI's consumer-friendly guidelines for care help providers identify and incorporate best clinical practices for their patients.

Main Street Medica: Understanding the cost variations that exist among providers can help you make more informed choices about your care. Use the resources at Main Street Medica to see cost comparisons for a variety of common procedures and conditions at Minnesota facilities and primary care clinics.

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Date: 10/22/2017 11:24:35 PM Version: 4.0.30319.42000 Machine Name: PWIM4-CMSWEB01