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NCQA: Health Quality Plateauing

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Many health quality measures have stagnated this year, and results for mental health and substance abuse care remain “dreadful,” according to health quality group.

The National Committee for Quality Assurance, Washington, says the country could avoid up to 115,000 deaths per year if all plans in its database performed as well as the plans that rank in the top 10%.

The NCQA is the nonprofit group that runs the Healthcare Effectiveness Data and Information Set program. Many employers and some government health agencies now require the plans they use to report HEDIS data to the NCQA.

The NCQA has based its latest quality report on HEDIS data from 979 health plans.

The plans that provided data for the current report cover a total of 116 million U.S. residents, up 9% from 106 million in 2008, the NCQA says.

The commercial plans turned in better results for 43% of the 51 “trendable measures” assessed, and the differences between the health maintenance organizations and the preferred provider organization plans that are participating has narrowed, the NCQA says.

Medicaid plans showed improvement on 36% of their 50 trendable measures, and Medicare plans showed improvement on just 14% of their 36 trendable measures.

Participating plans are doing very well in improving some measures, such as the percentage of patients with asthma who receive appropriate medications, the NCQA says.

Asthma patients are getting appropriate medications about 90% of the time, the group says.

But plans meet the antidepression medication management benchmark only 46% of the time, and they provide appropriate follow-up care for children prescribed medication for attention deficit hyperactivity disorder only 34% of the time.

Meanwhile, plans continue to report mediocre results on measures involving overuse of care, such as overuse of antibiotics and overuse of imaging technology for patients with low back pain, the NCQA says.

The NCQA also is continuing to find big regional variations in care quality.

“New England health plans are about 16% more likely to treat diabetic patients according to accepted guidelines compared with health plans in South Central states,” the NCQA says. “New England health plans [also] were 19.2% more likely to ensure that all patients received all appropriate cancer screenings compared with health plans in South Central states.”


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