Sansum Clinic was recognized today for providing high-quality care to Medicare Advantage (MA) patients by the Integrated Healthcare Association (IHA), a statewide nonprofit group committed to high-value, integrated care that improves quality and affordability for patients across California and the nation.
Building on the Medicare Advantage star rating system for health plans, IHA uses 13 clinical quality measures to collect performance data and assign star ratings to 186 physician organizations.
Those are based on how well the health plans provided recommended care in 2015 to some 2 million California seniors and people with disabilities enrolled in MA health maintenance organizations (HMOs).
Clinical quality measures used to calculate the star ratings range from rates of breast and colorectal cancer screenings to eye exams and blood sugar control for patients with diabetes to managing osteoporosis in women with a previous fracture.
Collecting these measures at the physician organization level allows IHA to combine data from the six participating health plans to identify performance variations that can help plans and POs target quality improvement efforts.
Each year, IHA recognizes physician organizations that achieve a 4.5- or 5-star rating. Sansum Clinic attained a 4.5 star rating for 2016-17, which reflects care provided to MA patients in 2015.
“We are committed to performance measurement and quality improvement, and we are proud to be recognized for the high-quality care we provide to our Medicare Advantage patients,” said Dr. Marjorie Newman, assistant medical director of Sansum Clinic.
“Through Medicare Advantage stars quality measurement, we recognize physician organizations that are committed to providing integrated care that helps make sure their patients get important recommended care,” said Dr. Jeffrey Rideout, IHA president and CEO.
“We believe California is the only state in the country providing overall MA star quality ratings at the physician organization level, and we applaud all California physician organizations for leading the way in making health care quality more transparent,” he said.
Along with recognizing high-performing physician organizations, IHA partners with the California Office of the Patient Advocate (OPA) to use the physician organization star ratings to report publicly on the quality of care for people enrolled in MA plans.