NCQA: Health Quality Scores Plateaued in 2008

WASHINGTON — After more than a decade of steady gains, health plans are seeing the plateauing of some quality improvement scores, according to a report from the National Committee for Quality Assurance.

“We feel frustrated that we don't seem to put our power behind what we really want,” NCQA president Margaret E. O'Kane said at a press briefing held to announce the results. “The status quo is still unacceptable,” she added.

The report included 2008 data from a record 979 plans (702 health maintenance organizations and 277 preferred provider organizations) that collectively cover 116 million Americans.

Plans recorded improvement on a few measures. For example, on average, 79.1% of patients in commercial plans (up from 74.4% in 2006) were successfully monitored while they took certain medications such as diuretics.

And among Medicare Advantage plans, the percentage of acute myocardial infarction patients who received beta-blockers at discharge and stayed on them for at least 6 months climbed 10.1 percentage points, to an average of 79.7%, during the same time period.

In addition, some areas of care seemed to plateau because they had reached their maximum potential. For instance, the percentage of children and adults with persistent asthma who were prescribed asthma medications stayed steady at more than 92%.

But there is room for improvement in other areas, Ms. O'Kane said. Among commercial plans, for example, 57% of measures showed no statistically significant improvement from 2006 to 2008; that figure was 64% in Medicaid plans and 86% in Medicare plans.

Among Medicare Advantage plan members, no improvement was seen on measures assessing medication use in arthritis or screening for cervical cancer. Furthermore, the percentage of Medicare patients who had poor serum glucose control did not decline as hoped.

Measures with overall plan compliance less than 50% included follow-up of children on attention-deficit/hyperactivity disorder medications (34%), initiation of alcohol/drug dependency treatment (43%), and monitoring of patients on antidepressants (46%).

Although the recession has taken its toll on some plans' quality budgets, Ms. O'Kane pointed out that achieving higher quality does not necessarily involve spending more money.

She noted that some health plans achieved quality ratings in the highest quartile for care of diabetes patients even as they were in the lowest quartile for expenditures on those patients. Emulating those plans “is where the trend should be moving,” she said.

Ms. O'Kane made the following recommendations for moving quality improvement forward:

▸ Create insurance exchanges and require plans to report quality and patient satisfaction data.

▸ Tie payment to performance.

▸ Expand demonstrations of the patient-centered medical home, and increase payments for primary care.

▸ Provide funding for developing, maintaining, and updating quality measures.

▸ Introduce quality bonuses for Medicare Advantage plans.

▸ Invest in Medicaid measure development.

The data were incomplete because some health plans didn't submit data and because fee-for-service programs, such as Medicare, typically do not have quality tracking mechanisms, which was a limitation of the report, Ms. O'Kane noted. “We lack comprehensive data for 83% of Medicare beneficiaries, 75% of Medicaid beneficiaries, and 44% of commercially insured patients,” she said.

DMARD Treatment Rates in Rheumatoid Arthritis Patients, by Payer

Source Elsevier Global Medical News

WASHINGTON — After more than a decade of steady gains, health plans are seeing the plateauing of some quality improvement scores, according to a report from the National Committee for Quality Assurance.

“We feel frustrated that we don't seem to put our power behind what we really want,” NCQA president Margaret E. O'Kane said at a press briefing held to announce the results. “The status quo is still unacceptable,” she added.

The report included 2008 data from a record 979 plans (702 health maintenance organizations and 277 preferred provider organizations) that collectively cover 116 million Americans.

Plans recorded improvement on a few measures. For example, on average, 79.1% of patients in commercial plans (up from 74.4% in 2006) were successfully monitored while they took certain medications such as diuretics.

And among Medicare Advantage plans, the percentage of acute myocardial infarction patients who received beta-blockers at discharge and stayed on them for at least 6 months climbed 10.1 percentage points, to an average of 79.7%, during the same time period.

In addition, some areas of care seemed to plateau because they had reached their maximum potential. For instance, the percentage of children and adults with persistent asthma who were prescribed asthma medications stayed steady at more than 92%.

But there is room for improvement in other areas, Ms. O'Kane said. Among commercial plans, for example, 57% of measures showed no statistically significant improvement from 2006 to 2008; that figure was 64% in Medicaid plans and 86% in Medicare plans.

Among Medicare Advantage plan members, no improvement was seen on measures assessing medication use in arthritis or screening for cervical cancer. Furthermore, the percentage of Medicare patients who had poor serum glucose control did not decline as hoped.

Measures with overall plan compliance less than 50% included follow-up of children on attention-deficit/hyperactivity disorder medications (34%), initiation of alcohol/drug dependency treatment (43%), and monitoring of patients on antidepressants (46%).

Although the recession has taken its toll on some plans' quality budgets, Ms. O'Kane pointed out that achieving higher quality does not necessarily involve spending more money.

She noted that some health plans achieved quality ratings in the highest quartile for care of diabetes patients even as they were in the lowest quartile for expenditures on those patients. Emulating those plans “is where the trend should be moving,” she said.

Ms. O'Kane made the following recommendations for moving quality improvement forward:

▸ Create insurance exchanges and require plans to report quality and patient satisfaction data.

▸ Tie payment to performance.

▸ Expand demonstrations of the patient-centered medical home, and increase payments for primary care.

▸ Provide funding for developing, maintaining, and updating quality measures.

▸ Introduce quality bonuses for Medicare Advantage plans.

▸ Invest in Medicaid measure development.

The data were incomplete because some health plans didn't submit data and because fee-for-service programs, such as Medicare, typically do not have quality tracking mechanisms, which was a limitation of the report, Ms. O'Kane noted. “We lack comprehensive data for 83% of Medicare beneficiaries, 75% of Medicaid beneficiaries, and 44% of commercially insured patients,” she said.

DMARD Treatment Rates in Rheumatoid Arthritis Patients, by Payer

Source Elsevier Global Medical News

WASHINGTON — After more than a decade of steady gains, health plans are seeing the plateauing of some quality improvement scores, according to a report from the National Committee for Quality Assurance.

“We feel frustrated that we don't seem to put our power behind what we really want,” NCQA president Margaret E. O'Kane said at a press briefing held to announce the results. “The status quo is still unacceptable,” she added.

The report included 2008 data from a record 979 plans (702 health maintenance organizations and 277 preferred provider organizations) that collectively cover 116 million Americans.

Plans recorded improvement on a few measures. For example, on average, 79.1% of patients in commercial plans (up from 74.4% in 2006) were successfully monitored while they took certain medications such as diuretics.

And among Medicare Advantage plans, the percentage of acute myocardial infarction patients who received beta-blockers at discharge and stayed on them for at least 6 months climbed 10.1 percentage points, to an average of 79.7%, during the same time period.

In addition, some areas of care seemed to plateau because they had reached their maximum potential. For instance, the percentage of children and adults with persistent asthma who were prescribed asthma medications stayed steady at more than 92%.

But there is room for improvement in other areas, Ms. O'Kane said. Among commercial plans, for example, 57% of measures showed no statistically significant improvement from 2006 to 2008; that figure was 64% in Medicaid plans and 86% in Medicare plans.

Among Medicare Advantage plan members, no improvement was seen on measures assessing medication use in arthritis or screening for cervical cancer. Furthermore, the percentage of Medicare patients who had poor serum glucose control did not decline as hoped.

Measures with overall plan compliance less than 50% included follow-up of children on attention-deficit/hyperactivity disorder medications (34%), initiation of alcohol/drug dependency treatment (43%), and monitoring of patients on antidepressants (46%).

Although the recession has taken its toll on some plans' quality budgets, Ms. O'Kane pointed out that achieving higher quality does not necessarily involve spending more money.

She noted that some health plans achieved quality ratings in the highest quartile for care of diabetes patients even as they were in the lowest quartile for expenditures on those patients. Emulating those plans “is where the trend should be moving,” she said.

Ms. O'Kane made the following recommendations for moving quality improvement forward:

▸ Create insurance exchanges and require plans to report quality and patient satisfaction data.

▸ Tie payment to performance.

▸ Expand demonstrations of the patient-centered medical home, and increase payments for primary care.

▸ Provide funding for developing, maintaining, and updating quality measures.

▸ Introduce quality bonuses for Medicare Advantage plans.

▸ Invest in Medicaid measure development.

The data were incomplete because some health plans didn't submit data and because fee-for-service programs, such as Medicare, typically do not have quality tracking mechanisms, which was a limitation of the report, Ms. O'Kane noted. “We lack comprehensive data for 83% of Medicare beneficiaries, 75% of Medicaid beneficiaries, and 44% of commercially insured patients,” she said.

DMARD Treatment Rates in Rheumatoid Arthritis Patients, by Payer

Source Elsevier Global Medical News