MANAGED CARE November 2005. ©MediMedia USA
Two trends are apparent in the National Committee for Quality Assurance's annual report on health plans. In the eyes of the organization, here's the bad trend: The rise of consumer-directed health plans, which do not yet measure and report on quality. Only about 21.5 percent of the industry reports publicly on its performance. (For more on that, see "NCQA Wonders: Who Keeps Tabs On Consumer Plans? [1]") Now, according to the NCQA, here's the good trend: A push for pay-for-performance strategies at all levels of the system.
Meanwhile, for those health plans that do report, the numbers look swell. The NCQA says that, "among the 289 commercial health plans that reported their data, average performance improved on 18 of 22 clinical measures." The plans provide care for about 65 million Americans.
Except for breast cancer screening, care measures improve at commercial plans
*Lower rates are better for this measure.
Note: The numbers reflect the percentage of people enrolled in commercial plans (HMO and POS) that receive the proper care (e.g., 84.8 percent of people enrolled in publicly reporting commercial plans will get beta-blocker treatment after a heart attack).
Source: The State of Health Care Quality 2005, National Committee for Quality Assurance