HMOs Improve on Preventive Measures, NCQA Finds

More Americans enrolled in HMOs are receiving preventive treatments such as screenings and blood pressure medications, and are also reporting greater satisfaction with their health plans, according to a report released Sept. 6 by the National Committee on Quality Assurance. The AP/Milwaukee Journal Sentinel reports that NCQA compiled data from the year 2000 from the 372 HMOs it has accredited, which cover 63 million Americans and represent about 65% of all HMOs. The average percentage of heart attack patients in the HMOs surveyed who had received cholesterol screenings increased from 69% in 1999 to 74% in 2000; 52% of patients with high blood pressure were treated for their condition, up from 39% in 1999; and 48% of individuals with diabetes, which can cause blindness, received eye exams, up from 45%. And in 2000, 66.6% of HMO enrollees said that customer service was "not a problem," up from 64.5% in 1999 and 53.9% in 1998. The report did find that HMOs could do a better job of screening for chlamydia and following up on mental health treatments.

Praise and Criticism
Gregg Meyer, who works on patient safety at HHS, said, "Improvements in health care are often measured a percentage point at a time, but this year we're seeing something different: more rapid gains in plan performance." American Association of Health Plans president Karen Ignagni, referring to the current debate over patients' rights legislation, said, "Congress should step back and carefully look at these results. The sad irony is that even as some in Congress debate new ways to sue health plans, a new report shows that managed care has made some significant strides in all areas of quality improvement for the second year in a row" (AP/Milwaukee Journal Sentinel, 9/7). Some "critics" of the HMO industry, however, said that the NCQA report does not take into account such factors as provider reimbursements and doctor-to-patient ratios. Jamie Court, director of Consumers for Quality Care, an advocacy group, said, "HMOs may be improving on preventive health measures where they know they're being rated, but that's far different than providing access to care for chronic, catastrophic or emergency conditions" (Appleby, USA Today, 9/7). The full NCQA report can be found online.