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Categories: Featured Articles, Newsletter, Newsletter Issue 2016:3

Data on Provider Market Structure: The MHQP Master Provider Database

Meredith Rosenthal
Harvard T.H. Chan School of Public Health

Massachusetts Health Quality Partners (MHQP) is a nationally recognized, non-profit coalition of physicians, hospitals, health plans, purchasers, patient and public representatives, academics, and government agencies. MHQP’s mission is to drive measureable improvement in health care quality, patients’ experiences of care, and use of resources in Massachusetts through patient and public engagement and broad-based collaboration among health care stakeholders, including physicians, hospitals, health plans, purchasers, patient and public advocates, government agencies and academics.

MHQP reports reliable, actionable information to healthcare providers to improve the care they deliver to their patients and to consumers so they can understand and improve the quality of their own care (healthcarecompassma.org). In addition, MHQP is able to sell data sets to researchers, policy makers, and others for analysis that leads to a better understanding of the health care sector and the forces that shape it.

MHQP’s Massachusetts Provider Database (MPD) captures the structure of ambulatory care in Massachusetts and provides a location-based snapshot of Massachusetts providers. It is the only valid data source available that maps primary care and specialty providers statewide to the practice site, medical group and network in which they provide care. The MPD is updated and validated annually. The MPD is an essential research resource used by academic researchers, health plans, government agencies and provider organizations to link to other databases, including the Massachusetts All Payer Claims Database. For example, with such a linkage, the MPD can be used to examine provider consolidation in Massachusetts and its impact on referrals to affiliated vs. unaffiliated specialists, the total cost of care, and readmission rates.

The MPD includes:

  • Comprehensive primary care physician data, as well as specialists, nurse practitioners and physician assistants
  • Over 30 provider data elements including name, address, provider specialty and role, and affiliated practice sites, medical group and network
  • A unique, single provider identifier which identifies providers practicing in multiple sites
  • Historical snapshots dating back to 2010
  • Core data extracts identifying provider practice location as of December 31 each year
    • Hierarchy of Providers in the MPD

      The MPD is structured according to the hierarchy of provider organizations in Massachusetts as shown in the figure below. The database includes 5,800 primary care physicians and 15,400 specialists (the lowest level of analysis – “providers”). These providers are nested within 4,700+ practices and 145 medical groups. Nine systems are also represented in the data.

      [ Hierarchy of Providers in the MPD ]

      MHQP MPD Provider Definitions

      Network: An organization of medical groups and/or practice sites with an integrated approach to quality improvement that enters into contracts with payers on behalf of its provider members.

Medical Group: A “parent” provider organization that may include multiple practices and practice sites. These can be single specialty or multi-specialty organizations and may exist within a broader network structure. 

      Practice Site: One or more providers who practice together at a single location (i.e., same mailing address, including suite number). These may be independent or part of a broader medical group or network structure.

      Provider: Licensed professional who offers medical care at one or more practice sites. These include physicians, nurse practitioners, and physician assistants. They are listed in each location where they practice.

      To discuss how the MHQP Massachusetts Provider Database can support your research, analytic or reporting efforts or to license the MHQP MPD for your research, analytic and reporting projects please contact Janice Singer, jsinger@mhqp.org or call (617) 600-4959.