Practice Pattern Variation Analysis

Doctor and patient looking at a test results An important aspect of improving patient care in Massachusetts is to ensure the appropriate use of health care services. MHQP is bringing together providers and payers from across Massachusetts to identify, learn about, and discuss variation related to how physicians treat patients for similar conditions. Practice pattern variation analysis (PPVA) is an approach to understand unexplained and sometimes unwarranted provider variation in care that could negatively impact patient quality of care.

MHQP has developed a multi-payer PPVA program that is grounded in data analysis and physician-driven. Through a respectful and accountable process that engages and deepens physicians’ and others’ understanding of practice variation, MHQP’s PPVA program provides analytic tools (e.g., data and training) and statewide opportunities for clinical community collaboration. MHQP is among the first organizations in the nation to bring payers and providers together to work with data from a state's all payer claims database (APCD)—in this case Massachusetts’ APCD—to improve healthcare quality across the state.

Guided by review of our initial analysis in 2014, with a stakeholder group of 30 physicians representing 14 medical specialties, the PPVA program is currently focusing on two treatments/conditions—back joint degeneration/back surgery and ischemic heart disease/catheterization—in its efforts to establish best practices for care and to reduce variations in care.

Practice pattern variation analysis can lead to improvements in healthcare quality and cost efficiency by reducing unnecessary or inappropriate care. Through the use of PPVA, the medical community can work together to determine actions and interventions that will result in appropriate, high quality care for patients while addressing costs and resource use.

For more information on the PPVA program, including details on how physicians and payers can join the effort, please email Janice Singer at


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