Consumer Reports rates physician practices.

Consumers in Massachusetts are about to find out what their fellow residents think about the quality of primary care in the state.

Consumer Reports, in collaboration with Massachusetts Health Quality Partners, released ratings on 329 adult primary care practices and 158 pediatric practices based on survey responses from 47,565 adults and 16,530 parents about their experiences in receiving care at those practices.

Massachusetts--which enacted a health reform law in 2006 requiring residents to buy insurance--is considered a model for the federal Affordable Care Act.

Interestingly, although demand for care expanded, survey responses showed that, for the most part, residents did not have trouble getting to see a physician. A total of 38% said that they did not get an appointment that they needed right away.

The ratings are included in a special 23-page insert in the newest Consumer Reports magazine and will also be available free of charge on the websites of both MHQP and Consumer Reports.

MHQP designed the survey, and its questions reflect the Institute of Medicine's evidence-based recommendations on what makes good primary care, Barbra Rabson, executive director of MHQP, said in an interview. The survey has been used by the nonprofit group every 2 years since 2006 to measure patient experiences and feed them back to physicians in an effort to improve the quality of care in Massachusetts, Ms. Rabson said.

The MHQP board decided a year ago to partner with Consumer Reports as a way to make the data more widely available, she explained, adding that, although there were always plenty of hits on the MHQP website every time it released new survey data, interest would fade with time and many consumers weren't even aware that MHQP had such data.

MHQP aims to reach as many consumers as possible and get them to be more interested in the quality of their care. "We're really trying to get the public to he, certainly more engaged, but we also want them to increase their expectations about how good their health care could be," she said, adding that the survey data can help build those expectations.

For physicians, it is crucial for them to hear the patient, said Ms. Rabson. "If you don't listen to the patient's voice, how can you possibly have a patient-centered health care system?"

MHQP--established in 1995--is a coalition that includes physicians, hospitals, health plans, purchasers, patient and public representatives, academics, and government agencies. When the group began discussing the Consumer Reports collaboration, some physicians were in favor. They felt that the MHQP survey was validated and evidence based, which meant that good data would be widely distributed. Others were hesitant because they did not want to be considered a product like a toaster or an automobile--the traditional purview of Consumer Reports' reviews, she said.

The data should not be a surprise to physicians, since they already received the survey results last fall, said Ms. Rabson.

In the ratings, physicians are given a score from 1 to 4 (with 4 being the highest) in each of five performance measures: how well doctors communicate with patients; how well they coordinate care; how well they know their patients; whether patients can get timely appointments, care, and information; and whether patients get courteous and respectful help from office staff Patients also were asked whether they would recommend the practice to a friend or family member.

A total of 13 of the 329 adult practices and 1 of the 158 pediatric practices had the highest score in each of the five measures. Only practices with three or more physicians were. included. The data were not broken down further into how many practices were top, middle, or bottom tier. High-scoring practices were found across the state--in rural, suburban, and urban areas--and in a variety of settings, such as in academic and private practices.

All of the survey respondents had health insurance. Individual physicians were not rated.

In the excerpts published in the insert, a majority of patients--more than 80%--said that they felt their physician always explained things in a way that was easy to understand, listened carefully to them, and spent enough time with them. This was not always the case, said Ms. Rabson. Low marks in previous surveys have spurred physicians in the state to work hard at improving the quality of their communications with patients, she said.

Doctors received lower marks for coordinating care with specialists, for their knowledge of the patient as a person, for including the patient's values and beliefs, and for asking about stress and depression.

Only 39% of patients surveyed said that their doctor always asked them whether they had periods when they felt sad, empty, or depressed.

MHQP would like to repeat the Consumer Reports collaboration when it surveys patients again in 2013, but it must line up funding_ The partnership was funded by a grant from the Robert Wood Johnson Foundation.

RWJF also is supporting Consumer Reports' collaborations with two other quality improvement organizations: Minnesota. Community Measurement and the Wisconsin Quality Collaborative. Minnesota will release clinical quality and cost data to the public in September and Wisconsin will issue ratings on preventive care measures later this year.