Health Insurance - Connecticut

Five of the state's largest health insurance companies and the Centers for Medicare & Medicaid Services (CMS) have begun to aggregate some of their patient data and share it with Connecticut physicians as part of a new venture that aims to improveAngelo Carrabba, immediate past president, Connecticut State Medical Society quality care in the stateThe partnership, which is called the Connecticut Health Quality Cooperative, represents the first time that health insurance companies in the state have agreed to combine their patient data and deliver it as a single source of information to doctors, officials said.

'This will give physicians one of the most complete and realistic evaluations of the type of care they are providing to their patients,' said Angelo Carrabba, immediate past president of the Connecticut State Medical Society. 'It gives physicians critical information to evaluate what's happening in their practice and allows them to compare it to statewide averages.'

Aetna, Anthem Blue Cross and Blue Shield of Connecticut, ConnectiCare, Health Net of the Northeast, and UnitedHealthcare will be providing their respective patient data for aggregation.

CHQC's focus will initially include data related to diabetes, coronary heart disease, asthma, childhood respiratory infections and several preventive measures such as testing for cervical and breast cancer and high cholesterol.

Qualidigm, a national health care consulting and research company based in Rocky Hill, is responsible for accessing Medicare claims data and combining it with the information provided by the health insurers.

Qualidigm will also analyze the information and produce quality performance reports.

About 3,000 to 4,000 physicians in pediatrics, internal medicine, obstetrics and gynecology, endocrinology, cardiology and family practice will have access to the data initially.

Doctors will not be provided information about individual patients. Instead, they will receive an aggregate summary of data from all of their patients who are members of the participating insurance companies.

Carrabba said the data will cover about 95 percent of insured individuals across the state.

For example, a doctor can receive data on the number or percentage of their diabetes patients who received annual eye exams or the number of their female patients who received annual cervical or breast cancer screenings.

Doctors will then be able to compare their statistics to statewide averages to see how their care stacks up against others in Connecticut.

If there are major discrepancies in the numbers, it could signal an area where doctors need to improve their care.

The expectation is that physicians will use the information to identify opportunities for improvement in their practices, officials said.

'It's not only critical to collect the data but to also act on it,' said Matthew Katz, executive vice president of the Connecticut State Medical Society. 'This allows physicians to examine why things are, or are not, being done and then to come up with a plan to make changes in patient care if necessary. The goal is to look at how uniform care is being provided across the state.'

The initiative also offers physicians a continuing education course on performance improvement and the use of data to drive improvement.

Physicians can access the data through a Web site, and patient information is private and managed according to federal confidentiality and security requirements, Carrabba said.

Funding for the CHQC comes from the participating organizations. The UConn Foundation is also providing funds for a continuing medical education module for physicians. Project collaborators hope to attract additional funding from foundations and health care purchasers as the program expands.

CHQC was launched by eHealthConnecticut. That organization, which is backed by a 25-person board consisting of consumers, health care providers and employers, has been contracted by the state to create a health information exchange for health care providers and patients in Connecticut. It has been working to accomplish that task since 2006.

In recent weeks, eHealth joined forces with another coalition of health-care providers that was also working to implement a statewide health information exchange, Carrabba said.

The group, which called itself 'Transforming Healthcare in Connecticut Communities,' or THICC, included a network of Connecticut's leading hospitals, physician practices, employer groups and insurers.

Some members of THICC have now joined the board of eHealthConnecticut, Carrabba said. They are working together to apply for grants from the federal government that will provide them funding to implement the exchange, Carrabba said.

Ron Blumenfeld, vice president and senior medical director at ConnectiCare, said he hopes CHQC will serve as a foundation for other types of data sharing in the future. He said it will be a key factor in dramatically improving patient care in Connecticut.

'Sharing more data will make it more useful and relevant for doctors,' Blumenfeld said. 'That benefits everyone.'