Health plan's quaility of care improved in U.S. for 2007
03 10 08 - 11:46
U.S. health care improved in '07
Insurers covering Utah make some gains, losses, committee says
By Lisa Rosetta - The Salt Lake Tribune
A new report scrutinizing America's health plans shows that health care quality continued to improve in 2007, with significant advances in the treatment of high blood pressure, one of the leading causes of death and disability.
For nine years in a row, the health care delivered by participating health plans has continued to improve despite rising costs and a slowing national economy, based on data gathered by the Healthcare Effectiveness Data and Information Set, or HEDIS.
Utah health plans that were included showed both improvements and setbacks in 2007. HEDIS looks at 54 measures, such as whether people are receiving flu shots, cancer screenings and comprehensive care for chronic conditions like diabetes.
"These are areas where there is broad-based consensus about what the best care is for patients," said Jeff Van Ness, a spokesman for the National Committee for Quality Assurance, or NCQA.
The report, the "State of Health Care Quality," is based on data collected from more than 800 health plans and is published annually by NCQA.
In Utah, not all health plans report HEDIS data. The ones that do, however, made collective gains in some areas, such as the use of imaging studies for lower back pain and using the appropriate medications for people with asthma. In other areas, though, they slipped below the national average. These included screenings for breast and colorectal cancer and for chlamydia,and in comprehensive diabetes care.
David Larsen, director of quality improvement for Utah insurer SelectHealth, said health plans in the state use the information to make changes. "We take this data very seriously," he said. "It's what drives our quality improvement initiatives for the plan. We take responsibility for our members - not just to pay their claims or set up a network of physicians to visit." Commercial plans showed statistical improvements in 16 of 54 of the measurement areas, including asthma medication management, blood pressure control and postpartum care for mothers and newborns. Both Medicare and Medicaid health plans, by contrast, reported relatively flat performances; in some areas, Medicaid plans got worse. There was a sharp decline, for instance, in the persistent use of beta blocker drugs after a heart attack despite evidence that such inexpensive treatment reduces the likelihood of another heart attack. Even within both commercial and public health plans, there are differences in the quality of care by region, the report shows. Among the eight census regions, the Mountain region - which includes Utah - posted the second lowest average performance. The best performing plans were in New England. Such unexplained variations in care, the report says, cost money - and lives. Differences in breast cancer screening, for example, cause an estimated 500 to 1,900 avoidable deaths and $212 million to $232 million in avoidable hospital costs. Controlling high blood pressure for some health plan members and not others leads to 14,000 to 34,000 avoidable deaths and $425 million to $1.1 billion in unnecessary hospital costs.
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