Quality: The Metric that Matters Most

In many ways, this holiday season will more closely resemble what we all had grown accustomed to before the COVID-19 pandemic. As we can travel and gather more freely and with fewer restrictions, we should also be anticipating – and preparing for – the most difficult flu season we have experienced in three years.

Already, we are seeing increases in respiratory illnesses across the country. The Centers for Disease Control and Prevention estimates there have already been 4.4 million illnesses associated with influenza this season, compared with 9 million total cases the entirety of the 2021-2022 season. In the Mid-Atlantic region, we have already tracked 4,540 positive flu cases since August this year. Cases of RSV (respiratory syncytial virus) are on the rise in children; with very few cases in 2020-2021 because of quarantine and lockdown measures, children did not develop the same levels of immunity and natural protections that we ordinarily see.

During times like these, when illness spreads more rapidly in our communities and across the country, quality health care matters most.

In the Kaiser Permanente Mid-Atlantic region, our patients’ life expectancy is six years longer than the national average, according to published research. That statistic is no accident or coincidence. It is only possible because of the quality of care we consistently provide to our members.

When we consider a patient’s long-term health, it is important to recognize that most of one’s wellbeing is dictated by factors that take place outside of a health care setting. The social determinants of health, which refers to the conditions within our homes and our communities such as access to healthy food, a safe place to live, or access to transportation, have an outsized influence on a person’s health throughout their life.

The fact that so many contributors to health are beyond our direct control as health care providers does not absolve us of or limit our responsibility to ensure our patient’s wellbeing. On the contrary, this realization should only reinforce the critical nature of our role in managing our patients’ health and providing quality care.

I am proud to say that Kaiser Permanente’s Mid-Atlantic region has a strong record of prioritizing and delivering the highest level of quality care. And, we have done this consistently for many years. In fact, in September, our region received five out of five stars from the National Committee for Quality Assurance (NCQA) for our Medicare, Medicaid, and Commercial plans. Only three other plans in the nation received five-star ratings. On its own, this is a remarkable accomplishment.

Then, in October, the Centers for Medicare & Medicaid Services (CMS) rated Kaiser Permanente Mid-Atlantic’s Medicare health plan five out of five stars, which is the highest possible rating, for the 11th year in a row!

First and foremost, we can deliver this type of care to our patients because of our talented and dedicated workforce. None of these accolades would be possible without the people who transform our mission into the care experienced by our members.

Our health care workers have endured immense difficulties over the past few years and those challenges continue into this flu season. Spurred by the stresses of the pandemic, we are grappling with a nationwide shortage of health care workers that is overtaxing our existing staff. The fact that our region has retained these quality ratings and metrics is a remarkable achievement and testament to our incredible workers.

In addition to finding the best people, our secret to delivering high-quality care is embedded in our integrated model. Too often in health care today, patients get jostled to and from providers in a disjointed network. They essentially start from scratch with each appointment, meaning that critical details about their health history are likely to get lost.

Kaiser Permanente’s integrated system empowers us to deliver patient-centered care, where we recognize and appreciate the whole person. We have the nation’s most comprehensive electronic medical record system that follows the patient – from doctor to doctor, facility to facility and virtual to in-person. This connectivity allows our providers to understand and appreciate the conditions in which our patients live and generate care according to their individual needs.

Our team of primary care providers and specialists work together to identify our members’ needs and collaborate to create care plans. Members can transition seamlessly from a primary care provider to a specialist because all our providers are working within the same system.

One major way that Kaiser Permanente continues to distinguish itself from our peers is through our disease prevention efforts. Our electronic medical record prompts providers when a patient needs a screening or vaccination. We screen more regularly and more effectively for breast cancer, cervical cancer, colon cancer, lung cancer, and more than any other health plans in our region. We take a holistic approach to monitoring high-risk patients with diabetes, high blood pressure, and other chronic conditions. This flu season, we have vaccinated 33.3% of our members against influenza, compared with a 26.3% national average. From our remote monitoring technologies to testing for blood pressure even when our members come to get an eye exam, we are the very best in preventing, diagnosing, and treating diseases.

At the end of the day, we want to help our patients live long, healthy, happy lives. And, while there are numerous metrics that we look at to guide us in that work – such as the accessibility of our care, the diversity and equity we commit to, and the affordability of our services – there is one metric that rises above the others in importance. Quality will always be paramount. This is because quality matters. Quality improves and saves lives. Quality equates to safety, and safety means better outcomes for our members and better work environments for our teams. Every action that we take is intentional and in service of our goal to deliver high-quality care.