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Does everyone get good care?
We would like to think that every time we go to the doctor we get the right care and follow through with the things we need to do to stay healthy. However, that is not always the case. Quality of care varies depending on which hospital or medical office you go to and which doctor you see. On average, Americans only receive recommended care a little over half of the time. For example, on average, 46%, or 4 out of 10 Tennesseans with diabetes had a dilated retinal eye exam done by a doctor in 2007. In some of the best medical offices, doctors partnered with their patients so that 87%, or 8 out of 10 patients got the eye exam they needed.
How is good care determined?
Medical research provides evidence of what care results in good health for a patient. This information is used to develop 'standards of care' that doctors can use when treating patients. For example, studies show that breast cancer occurs more often in women once they reach 50 years of age. Based on this information, it is standard care to provide breast cancer screening to all women over age 50.
How is good care measured?
One way to measure the quality of care is by clearly defining the most important health services that should be provided to patients who have or are at risk for certain conditions. The number of people who actually got the service (a test, medicine, or some other form of care) out of all people that should have gotten the service is measured. For example, the number of women over the age of 50 who got a mammogram out of all of the women over age 50 that were seen by their doctor and should have gotten a mammogram is measured and presented as the rate of breast cancer screening.
Why are these ratings important to me?
The ratings reported are recognized nationally as essential health care services people need to stay healthy. Use of commonly accepted quality measurements allows comparison between levels of care provided in medical offices throughout the state and nation. Knowing the measurements (and the reasons for them) helps you understand the care you should be receiving, and also helps to know what health care services to ask for if you aren't already receiving them from your doctor.
How were topics selected for measurement?
Healthy Memphis Common Table is committed to bringing all groups together - those who give, get and pay for care - to discuss the quality of care in the Greater Memphis area. Based on what information could be retrieved, topics were chosen that represented essential care needed by the majority of people in our community.
Where does this information come from?
Each time you visit a medical office, a bill is sent to your insurance company. The bill has information about why you were seen and about the care you received. Information from all of the bills is added together to see how many patients got the care they needed.
Are all medical offices included in the report?
No. Some medical offices did not have enough data to be included in the report. If your doctor is not in any of the medical offices included in the report, the report can still help you understand how quality care is measured.
How are the stars assigned?
The National Committee for Quality Assurance (NCQA) is a national oversight organization that helps define benchmarks or goals for high-quality care. We used these benchmarks to develop a consumer-friendly rating system for medical group performance. A gold star indicates that a group received the best rating possible. The purple star indicates a good rating and an unfilled star is equal to a fair rating. To get the best rating, a group performed at or above the 90th percentile nationally. That means the group was as successful in providing evidence-based care to patients as the top 10% of highest-performing medical groups across the country. To get a good rating, a group performed at or above the 75th percentile compared to all other groups across the country (top 25% of highest-performing medical groups). Medical groups who did not reach the 75th percentile received a fair rating.
What are benchmarks?
A benchmark is a scale or yardstick that helps us understand, measure and compare information. When a medical office regularly provides care that gives better results, this sets the benchmark for other medical offices to achieve. To get the best care, look for a medical office that provides care and services based on benchmarks.
What is a percentile?
These scores show you which medical offices are among the top 10% and 25% of medical offices in providing the specific care or service. If your medical office has a score that is equal to or greater than the 90th percentile, that means they are providing recommended care or service more often than 90% of the medical groups across the country. Achieving the 90th percentile means that the medical office is among the top 10% of performers in the country. If your medical office has a score that is equal to or greater than the 75th percentile, that means they are providing recommended care or service more often than 75% of the medical groups across the country. Achieving the 75th percentile means that the medical office is among the top 25% of performers in the country. Comparing the performance of your medical office to offices across the country is one way to measure how likely you are to receive the right care at at the right time.
within the reports, and click for helpful information about the topic. 
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