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Report: Health Care Quality Improves but Varies Across Different Regions of the Country

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NCQA — The quality of health care for millions of Americans improved in 2007 but significant variations in performance continue to leave many people receiving substandard care, according to a report (State of Health Care Quality 2008) released today by the National Committee for Quality Assurance (NCQA). And while quality improved for most people in private health insurance plans, there was little improvement in the care delivered to those enrolled in Medicare and Medicaid, the nation’s two largest public health care programs.

Each year, NCQA examines the state of health care quality through data submitted by health plans across the country. NCQA uses data from the Healthcare Effectiveness Data and Information Set, or HEDIS(R), a set of measures that assess how often patients receive care that conforms to evidence-based guidelines. HEDIS measures assess a spectrum of care ranging from prevention to chronic disease management including immunizations, cancer screenings, advice to quit smoking, blood pressure control and medication management.

Commercial health plans showed improvements on 44 of 54 measures of health care quality, with 16 significant gains in such areas as blood pressure control and postpartum care for women and their newborns. In contrast, health plans serving Medicare beneficiaries posted gains on only 24 of 45 measures of care, and many of those improvements were quite small. One area of notable improvement was the rate at which Medicare beneficiaries were kept on life-saving beta-blocker drugs six months after suffering a heart attack.

There was little improvement in the quality of care provided to Medicaid beneficiaries. Among the 52 measures collected from Medicaid plans, only 26 showed any increase and most of those were very small. One exception: delivery of childhood immunizations.

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