Managed Care


Quality improves at nation's health plans

MANAGED CARE November 2005. © MediMedia USA
News and Commentary

Quality improves at nation's health plans

MANAGED CARE November 2005. ©MediMedia USA

Two trends are apparent in the National Committee for Quality Assurance's annual report on health plans. In the eyes of the organization, here's the bad trend: The rise of consumer-directed health plans, which do not yet measure and report on quality. Only about 21.5 percent of the industry reports publicly on its performance. (For more on that, see "NCQA Wonders: Who Keeps Tabs On Consumer Plans?") Now, according to the NCQA, here's the good trend: A push for pay-for-performance strategies at all levels of the system.

Meanwhile, for those health plans that do report, the numbers look swell. The NCQA says that, "among the 289 commercial health plans that reported their data, average performance improved on 18 of 22 clinical measures." The plans provide care for about 65 million Americans.

Except for breast cancer screening, care measures improve at commercial plans

*Lower rates are better for this measure.

Note: The numbers reflect the percentage of people enrolled in commercial plans (HMO and POS) that receive the proper care (e.g., 84.8 percent of people enrolled in publicly reporting commercial plans will get beta-blocker treatment after a heart attack).

Source: The State of Health Care Quality 2005, National Committee for Quality Assurance


4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015