Disclosing data makes for higher quality
NCQA managed care survey is out
The fourth edition of the National Committee for Quality Assurance’s (NCQA) the State of Managed Care Quality offers more proof that disclosing data makes plans perform better. While overall, managed care is improving the quality of care it offers patients, the survey shows particularly strong results among accredited plans and those that publicize their data.
"Across every single clinical quality measure NCQA examines, and in every region of the country, health plans that reported data made significant gains in 1999," the report states. The best performing region is New England, which has the largest number of accredited programs.
Based on Health Plan Employer Data Information Set (HEDIS) 2000 data, the report looks at clinical performance, accreditation, and member satisfaction data from 466 HMO and point-of-service plan products covering some 340 organizations. Another 101 managed care plans contributed their data, too.
There were 18 clinical and 10 nonclinical measures. Six of the clinical measures — asthma medication use, chlamydia screening, cholesterol control, comprehensive diabetes care, controlling high blood pressure, and management of menopause — are reported for the first time.
Among the specific data sets, one of the big improvements showcased in the report is in the use of beta-blockers. The report notes that in 1996, when the measure was first introduced by NCQA, managed care plans delivered them to heart attack patients about 62% of the time. By 1999, the average was up to 85%.
Another big improvement came in chickenpox vaccines, which were given only 40% of the time to 2-year-olds in 1997. Last year, that was up to 64%, representing more than 1,200 children who won’t be scratching their way through the disease.
Measles/mumps/rubella vaccines rose from 52% to 59% between 1998 and 1999, but among accredited plans, the rate was nearly 65%.
Accredited plans outperformed their nonaccredited counterparts in several areas, including cholesterol control — 48% vs. 41%, and diabetic eye exams — 49% compared to 40%.
Plans that report their data also do better. Beta-blockers are given 91% of the time to patients in plans that publicly report their data, compared to the 85% rate mentioned above.
And plans that do better clinically by their patients do better in patient satisfaction. Those that scored in the top 25% of all organizations on the range of clinical HEDIS measures also did a demonstrably better job of meeting their members’ service expectations.
Members of those plans were more likely to rate their health plan as good or excellent (63%) than members of the poor clinical performers (54%). They were also far more likely to give their plans high marks in such areas as "Getting Needed Care," "Customer Service," and "Claims Processing."
To see the entire report, go to the NCQA Web site at www.ncqa.org and click on the "news" link.
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