NCQA: Reports ‘Sufficient Gains’ for HMOs in 1999
While politicians often drub HMOs for "standing in the way" of quality health care, a new National Committee for Quality Assurance study showed that managed care plans have made "sufficient gains" in 1999, the Wall Street Journal reports. "As controversial as it sounds, and despite anecdotal accounts to the contrary, objective evidence shows that managed care is improving, in some cases substantially," NCQA President Margaret O'Kane said. The fourth annual NCQA study, based on an analysis of 466 health plans that cover about 51 million people, examined several clinical quality measures, such as vaccinations and health measures. According to the report, HMOs made the largest strides in heart disease prevention and childhood immunizations. In 1996, for example, only an average of 62% of managed care members received beta blocker prescriptions, but that number jumped to 85% last year. Screenings for high cholesterol also increased, rising from 59% in 1998 to 69% in 1999. In addition, only 41% of two-year-olds received chicken pox vaccinations in 1996, but the rate ballooned to more than 65% last year. Still, the survey also showed areas that needed improvement, such as asthma treatment, and wide variations among HMOs on some preventive measures, including diabetic eye exam rates, cervical cancer screening rates, and rates for controlling high blood pressure. The results, however, revealed a "sharp contrast" from those in recent years, which had raised concerns among many employers who feared HMOs could not "kee[p] the promise of disease prevention." Wayne Burton, medical director at Bank One Corp., said, "This is one of the largest jumps in improvements that we've seen. Over the years we've seen very little change in quality improvements." While the NCQA study showed improvements in many HMOs, it did not include all health plans (Martinez, 9/7). Many plans do not gather and process the needed information for the survey or refuse to allow the NCQA to report the results to the public.
Around the nation, California-based Kaiser Permanente had a "particularly strong performance" in the NCQA survey, especially in the area of data management (Rosenblatt, Los Angeles Times, 9/7). In Arizona, most HMOs performed "better than average" in testing diabetes, but scored poorly in member satisfaction (Erikson, Arizona Daily Star, 9/7). New England health plans "outperformed" those in all other regions in most areas, while the Mid-Atlantic region -- which had strong performances in evaluating care of depression, screenings for various diseases, immunization rates and chronic disease care -- finished second in many cases (Burling, Philadelphia Inquirer, 9/7). Meanwhile, Texas HMOs ranked below the national average in member satisfaction and quality of medical care (Lunday, Ft. Worth Star-Telegram, 9/7).