The True Skinny

As a board member for the Mercy Health Clinic, part of my job is to ask people to contribute money or time to support the clinic’s mission of providing top-quality health care to uninsured people in Montgomery County. But hold on. Who says it’s “top-quality”? You could just take my word for it if you know me and trust my judgment. Come to think of it, it would be awesome if you would just do that, and write that check or hit that Donate Now button. Thanks so much.

But if you don’t want to take my word for it, you might want to know how we measure “quality”. We could point you to our Facebook page – we’ve got 4.5 stars! That’s nice, but not that useful when you’re a potential donor or volunteer and want to get the true skinny on whether Mercy delivers the goods.

No, for this job you need data – statistics, in fact, comparing Mercy’s performance against a set of quality metrics agreed upon in advance for the 12 Montgomery Cares safety-net clinics operating in Montgomery County[1]. For the low-income, primarily immigrant population served by the safety-net clinics, several health issues show up more often than others: diabetes, hypertension, and various kinds of cancer. So we measure specific aspects of these conditions, comparing them to nationally endorsed specifications and (and this is important) evidence that improvement in the measure correlates with improved patient outcomes.

So how is Mercy doing? Here are just a few examples from the most recent statistics gathered for Montgomery Cares clinics by the Primary Care Coalition[2].

For diabetes, some key metrics compared across the clinics include:

  • screenings for HGBA1c, which measures blood glucose levels – 92% of Mercy patients with diabetes had a screening within the last year
  • annual retina exams to screen for diabetic retinopathy, a complication that can lead to blindness – 67% of Mercy patients with diabetes had an annual retina exam within the last year (#1 among the clinics!)
  • foot exams to detect loss of protective sensation or ulceration that can lead to amputation and disability – 60% of Mercy patients with diabetes had a foot exam within the last year (#2 among the clinics!)
  • blood pressure control, to stave off complications such as stroke and heart failure – 83% of Mercy patients with diabetes had BP less than 140/90 (#1 among the clinics!)

For hypertension, metrics include:

  • measurement of blood pressure – 100% of Mercy patients with hypertension had their BP measured within the last year
  • hypertension patients with their BP under control – 74% of Mercy patients with hypertension had their BP under control (#1 among the clinics!)

For cancer, metrics include:

  • women aged 50 – 74 had a mammogram to detect breast cancer within the past two years – 69% of Mercy female patients in this age range (2nd among the clinics)
  • women aged 24 – 64 had a PAP smear for cervical cancer within the last 3 years – 58% of Mercy female patients in this age range
  • patients aged 51 – 74 had a colon cancer screening performed within the last year – 54% of Mercy patients in this age range (1st among the clinics!)

Low-income and uninsured people often forego healthcare until their conditions are much farther along and thus more expensive and difficult to treat. Monitoring of chronic conditions such as diabetes and hypertension helps patients keep their disease under control and reduce the likelihood of secondary complications such as vision problems or lower-extremity amputations. Screenings for cancers help identify potentially deadly disease in its early stages when treatments can be more effective.

Another benefit? Cost. Safety-net clinics like Mercy help uninsured patients avoid using costly ER facilities for their primary care, thus helping keep costs down for all of us. Mercy Health Clinic’s model of care relies heavily on volunteers, and provides a diverse multidisciplinary team at our Gaithersburg site. This improves the options for treatment, as patients have access to a primary care physician, nutritionist, and a specialist if they need one. 

These measures are by no means an exhaustive assessment of clinic performance or patient outcomes, and they are a snapshot of performance, which can vary over time. But they do give some idea of what we’re measuring on a regular basis to determine if we’re making a difference in our patients’ lives, and what we mean when we say that Mercy provides top-quality healthcare. I hope you’ll click here to support the Mercy Health Clinic’s mission to make Montgomery County a healthier place for everyone, including those without health insurance. That would be awesome. 

— Pam Saussy, Board Member

[1] Montgomery Cares measures are benchmarked against NCQA’s HEDIS Medicaid performance. NCQA measures healthcare system performance including primary and specialty care. For details about Mercy Health Clinic’s patient outcomes, contact Mark Foraker, Executive Director, at mark.foraker@mercyhealthclinic.org.

[2] www.primarycarecoalition.org

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