Study: Health Care Quality, Use Vary Widely Across California
Details of Study
The study measured performance on various health care-related metrics, such as:
- Cancer screenings;
- Diabetes management;
- Emergency department visits; and
- Use of available health resources (Lyles, Sacramento Bee, 8/3).
The study broke down performance throughout the state, as well as by type of health plan, including:
- Medicare Advantage;
- Medi-Cal managed care plans; and
Medi-Cal is California's Medicaid Program (IHA study, July 2015).
The study used an online tool called HEDIS By Geography -- developed by IHA, the California HealthCare Foundation and 11 California providers -- to break down performance by region and county. CHCF publishes California Healthline (Sacramento Bee, 8/3).
Although health care quality and resource use varied significantly across California, the state still performed better on both measures than the U.S. overall.
Statewide, the study found about 228 ED visits per 1,000 member years.
Santa Cruz County had the lowest annual rate of ED visits of any county in the state, at 108 visits per 1,000 member years. Meanwhile, Kings County had the highest rate, at 353.5 visits per 1,000 member years (IHA study, July 2015).
Dolores Yanagihara, vice president of performance measurement at IHA, said, "Often whether or not someone will go to the emergency department relies on a combination of a county's availability of [EDs] and how accessible care is" (Sacramento Bee, 8/3).
The study also found that 10.2% of patients statewide were readmitted to the hospital after an initial stay.
In addition, California health plans that rely on integrated care delivery networks -- such as HMOs -- tended to have higher quality scores than Medicare fee-for-service plans or Medi-Cal managed care plans without using more resources, according to the study. For example:
- 84.5% of patients in HMOs were screened for breast cancer, compared with 69.7% of patients in PPOs; and
- 91.6% of patients in HMOs with diabetes had their blood sugar screened, compared with 80.7% of patients in PPOs.
This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.