Budget impact analysis estimate cost dynamics treating refractory gastroesophageal

HEDIS: LOOKING AT THE NUMBERS

A Managed Care magazine analysis of Quality Compass 98 — the National Committee for Quality Assurance’s annual compilation of HEDIS data — has blown the dust off of some controversial generalizations about the health plan industry. Our study of Quality Compass data indicates that on the whole, not-for-profit health plans tend to outperform for-profit plans on Health Plan Employer Data and Information Set measures. We also found that large national health plans can have large regional differences in quality of care and that pure HMOs appear to score higher than point-of-service plans.

This year, 447 plans reported HEDIS data to NCQA; 292 agreed to allow NCQA to make their scores public. NCQA offers that plans that publicly report data tend to score higher on HEDIS measures than plans that choose to keep their scores confidential. Similarly, NCQA-accredited plans outperform health plans that do not seek the NCQA seal.

In all charts, the numbers represent the percentage of enrollees eligible for the service who actually received it.

This article is also available in PDF


Our most popular topics on Managedcaremag.com