What NCQA thinks about quality
… but some insurers still won’t publicly report data
Health plans’ quality improvement efforts are yielding steady performance gains, but some insurers still refuse to publicly report their data, according to an annual report from the National Committee for Quality Assurance.
In its State of Health Care Quality 2011 report, released Oct. 13, the Washington-based not-for-profit healthcare quality and accreditation organization noted across-theboard improvements in areas such as colorectal cancer screening, and it emphasized the growing need for insurers to redefine themselves as drivers of quality and value.
“Plans are waking up to the fact that there are so many opportunities to improve,” Margaret O’Kane, the NCQA’s president, said in an interview. More insurers are focusing on areas such as chronic disease management, and are working with providers to curb rates of preventable hospital readmissions, she said.
For the report, the NCQA analyzed data on resource use, patient satisfaction and clinical quality, voluntarily submitted by more than 1,000 health plans—740 HMOs and 302 preferred provider organizations. This report also marks the first time the NCQA included PPO data for comparison with HMOs across all of the NCQA’s Healthcare Effectiveness Data and Information Set measures.
And although HMOs have traditionally led in healthcare quality, the data showed that PPOs have made significant jumps in performance in many areas, O’Kane said. For instance, commercial HMOs and PPOs had nearly identical scores—92.9% and 93%,