NCPA - National Center for Policy Analysis

Quality Scores Rise For Health Plans

August 19, 1999

For three years, the National Committee for Quality Assurance has been grading health care plans in dozens of areas of preventive and treatment measures. The test grades about 400 health maintenance organizations covering about 75 percent of the 80 million patients enrolled in plans nationwide. On the most recent report card, overall scores either rose sharply or stayed about the same.

  • The proportion of patients given beta blockers to reduce the risk of further problems after heart attacks rose to 80 percent in 1998 from 62 percent two years earlier.
  • The proportion of children who received a vaccination for chicken pox before their second birthday increased to 52 percent in 1998 from 40 percent just one year earlier.
  • However, there is a huge gap in the care provided by different plans -- for example, the Blue Cross plan in Portland, Me., treated almost 100 percent of heart attack patients with beta blockers, while HIP of New York gave them to only 54 percent.

Critics also contend that the improvements are due to the plans' "teaching to the test" -- providing the types of care they know will be measured -- and they say the test is woefully incomplete.

Few employers pay attention to the medical report cards, according to a recent KPMG survey. In part, that is because incomplete reports provide an unreliable guide to quality. In the survey, over 70 percent of large companies said cost was a major determinant of their choice of health plans -- but less than 10 percent said data on the quality of medical care was very important.

Source: Michael M. Weinstein, "The Grading May Be Too Easy on Health Plans' Report Cards," New York Times, August 19, 1999.


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