| Despite three straight years of improvements in the quality of health
care provided by HMOs, Americans could avoid more than 22 million sick
days each year if all HMOs adopted a "best practices" approach to
health care, according to the National Committee for Quality Assurance
(NCQA).
Top 15 NCQA-accredited HMOs
(Listed alphabetically)
- Anthem Blue Cross and Blue Shield, Connecticut
- Anthem Health Plans of Maine
- Anthem Health Plans of New Hampshire
- Capital Group Health Services of Florida
- Excellus Health Plan
- Fallon Community Health Plan
- Group Health Cooperative of South Central Wisconsin
- Harvard Pilgrim Health Care
- Harvard Pilgrm Health Care of New England
- HealthAmerica Pennsylvania
- Kaiser Permanente, Colorado
- Physicians Plus Insurance Corp.
- Security Health Plan of Wisconsin, Inc.
- Touchpoint Health Plan
- Tufts Health Plan
Source: National Committee for Quality Assurance |
In
its annual "State of Health Care Quality" report, the NCQA finds
significant improvements in key measures of health care by those plans
that report health care data for NCQA evaluation. However, the report
also finds that people who suffer from asthma, depression, diabetes,
heart disease, and hypertension lose an estimated 22,781,370 days from
work due to their medical conditions
.
Make
no mistake about it, says the NCQA, "opportunities for improvement
still abound" because the data that show improvement only covers about
one in four insured Americans. "The other three-quarters are likely to
receive care and service from providers and organizations that neither
measure nor report quality information." NCQA is a private, nonprofit
accrediting organization dedicated to improving health care quality.
Make
no mistake about it, says the NCQA, "opportunities for improvement
still abound" because the data that show improvement only covers about
one in four insured Americans. "The other three-quarters are likely to
receive care and service from providers and organizations that neither
measure nor report quality information." NCQA is a private, nonprofit
accrediting organization dedicated to improving health care quality.
According
to the report, the percentage of patients who had their blood pressure
treated rose to 55.4 percent in 2001 from 51.5 percent in 2000, and
from 39 percent in 1999. However, the NCQA also says Americans lose an
estimated 1.9 million days from work a year due to hypertension
NCQA
lists the top 15 NCQA-accredited HMOs in the country according to how
well they perform on the "Health Plan Employer Data and Information
Set," or HEDIS measures. HEDIS is a set of standardized performance
measures designed to ensure that employers and consumers have the
information they need to reliably compare HMO performance. The
performance measures in HEDIS are related to many public health issues
such as cancer, heart disease, smoking, asthma, and diabetes. According to NCQA spokesperson Brian Schilling, no other
health plan in the nation performed as well on the HEDIS measures as
Touchpoint Health Plan, a 160,000-member HMO in northeast Wisconsin.
Schilling says Touchpoint was among the first in the nation to earn an
"excellent" accreditation from NCQA and is the highest-performing plan
in the nation overall in the HEDIS measures. It set the national
benchmark in 2001 with the top scores in four measures, including:
- 90 percent of its patients received breast cancer screening.
- 100 percent received beta blocker treatment after a heart attack.
- 94 percent of diabetes patients received eye exams.
- 75 percent received cholesterol control.
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