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Report: Health Plans Have Improved, But Gains Were Fewer than Before

By Sasha Bartolf, CQ Staff

September 25, 2007 – The National Committee for Quality Assurance (NCQA) on Monday reported that the rate of improvement for American health plans has slowed compared to previous years. While the quality of care for more than 80 million Americans improved in 2006, the gains were smaller than they have been in the past, according to the group's State of Health Care Quality 2007 report.

According to the report, performance slowed for health plans participating in Medicare, and Medicare's managed care plans fared better in just 7 out 21 measures of care. But 44 more Medicare managed plans reported, for the first time, quality data in 2006, which brought the total number of publicly reporting plans to 211.

The NCQA report monitors performance trends over time, tracks variations in patterns of care, and provides recommendations for future quality improvement. The clinical quality, customer experience, and user data upon which the 2007 report was based were voluntarily reported to NCQA by more than 500 health plans.

The report also highlighted improvements in cardiac care, immunization rates, and colon cancer screening. In the area of cardiac care, the report found that in 2006, 99.7 percent of patients received a beta-blocker drug—medication that can reduce the possibility of a second heart attack—compared with 62 percent in 1996.

The percentage of children and adolescents being fully immunized was 80 percent in 2006 for those enrolled in commercial health plans and 73.4 percent for children in Medicaid, the report found. In addition, the percentage of Americans who received recommended screening for colon cancer also rose, from 52.3 percent in 2005 to 54.5 percent in 2006, according to report.

"For the 80 million Americans in accountable plans this is great news. These improvements mean better health and longer lives," said NCQA President Margaret E. O'Kane in a press release.

However, the report also warned that serious gaps in care persist. The group estimates that if the entire health care system were to perform as well as the top 10 percent of accountable plans they measured, between 35,000 and 75,000 deaths could be avoided each year. And in addition to lives saved, the economy would recoup $7.4 billion in lost productivity for the 45 million sick days taken, according to the report.

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