December 2008: Volume 34, Number 12
NCQA Report: Reform Must Tackle Uneven Care
While quality of healthcare in the U.S. continues to improve overall for the 9th consecutive year, Congress and the new administration must make the persistent variation in care a primary target of healthcare reform, according to the 2008 State of Health Care Quality report by the National Committee for Quality Assurance (NCQA). The report urges the new administration to set regional targets for both quality and efficiency and recommends that payments to both plans and physicians be tied to achieving these goals.
Despite some problem areas, the report shows a steady overall improvement in quality. NCQA applauded the surge of health plans that reported HEDIS measures of care, including a total of 240 PPO plans, up from 141 in 2006. Today, one in three Americans is enrolled in a health plan reporting quality measures, a 29% increase in the last year alone. The report emphasized that reporting HEDIS data has been shown to boost quality of care. In fact, taking into account the improvements in core measures since NCQA began monitoring data in 1996, more than 125,000 lives have been saved through more consistent delivery of care in accordance with evidence-based guidelines.
But NCQA notes that the rate of improvement has not been consistent across the country, and uneven quality of care is causing many avoidable deaths and leaving large swaths of the nation behind. The report points out that if all healthcare plans improved performance in key areas to match the quality of the top performing plans, many deaths could be avoided.
Looking at quality geographically, commercial health plans in New England exceeded the national HEDIS average by 4.7 percentage points, while plans in the Mid-Atlantic scored an average of 1.3 percentage points above the national average. Lagging behind, plans in the South Central region reported scores that average 4.0 points below the national HEDIS rate. The prevalence of quality reporting varies widely as well. In a broad area that cuts through the middle of the nation, roughly from Idaho down to Alabama, quality reporting is scarce or nonexistent, compared to much higher rates of reporting in the Northeast and West Coast. The report is available free from the NCQA website.