PREVENTIVE CARE: CDC Looks At HMO Performance
A new report by the Centers for Disease Control and Prevention examines the aggregate preventive services administered by HMOs to their patients nationwide, comparing rates of such services among states and regions. Published in the current issue of the CDC's Morbidity and Mortality Weekly Report, the study relied on the Health Plan Employer Data and Information Set (HEDIS), which reports on the performance of HMOs and is sponsored and maintained by the not-for-profit National Committee for Quality Assurance. The report surveyed preventive care provided to commercial HMO enrollees under age 65. While the 1996 HEDIS data used was drawn from only 320 HMOs in 42 states and Washington, DC, the CDC insists the data is comparable to the 660 HMOs nationwide by HMO type, regional location and tax status. To gauge the dispensation of preventive care in general, the study measured the particulars of mammography, Pap tests, retinal examinations for diabetics and advice to quit smoking (Morbidity and Mortality Weekly Report, 7/31 issue). "The survey is important because 37 million adult Americans -- about one in four -- now get preventive care through" HMOs, according to CDC epidemiologist Sharon Bloom. "This provides us with the ability to measure the quality of care," she said (AP/CNN.com, 7/31).
The survey found that nationwide, among women ages 52-64, 71.6% (+/-0.7%) received a mammogram in the preceding two years. Among women ages 21-64, 72.1% (+/-0.9%) were administered a Pap smear in the preceding three years. Among diabetics ages 31-64, only 40.8% (+/-1.0%) reported getting a retinal exam. Finally, among smokers ages 18-54 who had been to the doctor in the past year, 62.3% (+/-0.7%) reported being advised to quit (MMWR, 7/31 issue). The AP/Boston Globe reports that New England topped the regional rankings for preventive caregiving in an HMO setting. "In New England, 78% of women ... received mammograms through HMOs, compared to 64% of women in Alabama, Kentucky, Mississippi, and Tennessee"; 79% of the female HMO members in New England received Pap smears, contrasted with only 68% in the same block of four Southern states; and 68% of New England doctors warned their patients about smoking, compared to 50% of the Southern doctors (7/31). Click here to see the current MMWR, which is available online through the CDC's website -- www.cdc.gov.