QUALITY ASSESSMENT: Data Reporting = Better Performance
The National Committee for Quality Assurance today released its third annual "State of Managed Care Quality" report, drawing on measurements from the Health Plan Employer Data and Information Set (HEDIS), which NCQA uses to accredit and issue report cards on health plans nationwide. The report is based on an analysis of performance data from 247 companies representing 410 health plans and 70 million Americans. Among the report's most significant findings was that health plans with a track record of public disclosure outperform others and demonstrate improvement across all performance measures. For example, plans with a two- or three-year history of publicly reporting adolescent immunization rates outperformed those new to the reporting process by 25% (67.9% vs. 42.9%). NCQA President Margaret O'Kane said, "This report confirms that public accountability and rigorous performance measurement together are the keys to driving quality improvement. That's good news if you're served by an HMO or point-of-service plan that believes in accountability. But a large part of the managed care industry and the entire fee-for- service sector still need a wake-up call -- when nothing gets measured, nothing gets done." In addition, NCQA found that plans often make significant improvements following the introduction of a new HEDIS measure indicating that there is still room to improve in managed care. Dr. Jim Marks of the CDC's Center for Chronic Disease Prevention and Health Promotion said, "The dramatic performance improvements we tend to see following the introduction of a new HEDIS measure show there is a lot of low hanging fruit still out there. We stand to reap a windfall in terms of improved care and service with continued vigilance about measurement and reporting." Among the report's other findings: