Commercial plans lag behind Medicare plans on quality indicators

When it comes to health plans, big spenders don't always deliver the best care, according to the new State of Health Care Quality report from the National Committee for Quality Assurance, a private, nonprofit organization dedicated to improving healthcare quality.

Here's one striking example: Vaccination rates for kids with private plans dropped by nearly 4 percentage points, while rates continued to rise for children on Medicaid plans in 2009. It's possible that a popular misconception that ties vaccines to autism has driven some parents away from evidence-based recommendations.

The report examined quality data from over 1,000 health plans that collectively cover 118 million Americans and compared types of plan by category.

There's been a drop in patient satisfaction with health plans and physicians, according to NCQA. For example, while 64 percent of members with Medicare plans said they usually or always manage to get needed care, only 53 percent of members with commercial plans felt the same. The latter was a drop from a high of 80 percent in 2005.

Another area where commercial plans lag behind Medicare and Medicaid plans is monitoring of drugs, such as Digoxin, diuretics, anticonvulsants and ACE inhibitors, which patients use for at least six months.

Medicare (83 percent) and Medicaid plans (77 percent) also fared better than commercial plans when one compares the share of members who received persistent beta-blocker treatment for six months after discharge with a heart attack diagnosis. But the report does note that commercial health plans have seen a dramatic rise in those rates, more than 34 percent since 1996 to 74 percent in 2009. "Ultimately," the report notes, "what gets measured gets improved."

To learn more:
- read the report from the NCQA
- here's the NCQA press release

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