Plaintalk Blog: Understanding Health Care Quality in Colorado

If you’re a fan of the Simpsons, you’ve probably encountered an episode or two with the rather unconventional and reckless character, “Dr. Nick”. If you’re not familiar with Dr. Nick, all you need to know is that he was challenged by a Malpractice Board for performing surgery with a knife and spoon from a seafood restaurant. Long story short, no patient in their right mind would ever seek out care from this doctor if they knew how he practiced medicine.

In the health care world, we use the phrase “quality of care” as way to describe how a provider practices medicine. National guidelines are available to providers – including hospitals and doctors –to help them provide care according to the latest standards. These standards are intended to help patients who are healthy stay healthy and receive recommended preventive tests like breast cancer and colon cancer screenings. The guidelines also help ensure patients with chronic diseases live the highest quality life possible by doing things like prescribing appropriate medications for asthmatics, and testing blood sugar levels regularly to manage diabetes. (Learn more about these guidelines here)

Data in the Colorado All Payer Claims Database (CO APCD) can help Coloradans understand the quality of care provided in the state, an important measure of the overall value of health care. Information is also available on the cost of the care, but studies have shown that higher costs don’t necessarily result in higher quality of care and better outcomes for patients. Both cost and quality are important to evaluate for Coloradans to receive the highest value health care possible.

CIVHC makes data available publicly from the CO APCD, and recently released an interactive quality report showing how Colorado is doing on quality of care. A number of quality measures, based on the National Committee for Quality Assurance (NCQA) definitions, are available at the state, rural, urban, and individual county-level. Breakouts are also available by type of health insurance (Medicaid, Medicare Advantage and Commercial) to further understand where we have variation in how care is being delivered. The following quality measures are available with trend information from 2012:

• Appropriate Medication for Asthma
• Diabetes A1c Testing
• Breast Cancer Screening
• Cervical Cancer Screening
• Colorectal Cancer Screening

When looking at the data, there are some interesting trends and opportunities in Colorado:

• Of the available measures, Coloradans are receiving the highest quality of care related to receiving appropriate medications for asthma (89% of asthma patients are filling appropriate medications for their condition).
• The majority of Coloradans (72%) are not being screened as recommended for colorectal cancer. Denver Metro counties, including Boulder, and Mesa in Grand Junction have the highest percentages of people receiving colorectal cancer screenings, yet over 60% of people in these areas still do not receive a screening.
• Only 49% of women living in rural counties in Colorado are screened appropriately for breast cancer, compared to 58% of women who live in urban counties in the state. In 14 rural counties, only 60-78% of women receive breast cancer screenings.
• More patients who had commercial insurance in 2015 received cervical and colorectal cancer screenings than in 2012, but fewer people with Medicaid and Medicare Advantage received those same screenings.

These initial insights only provide a sliver of what can be learned from the CO APCD Quality report. Check out the interactive report to learn more about variation in the quality of care provided to Coloradans.

Curious about something? Have an idea about a future Plaintalk Blog? Let us know at info@civhc.org or by commenting below.