Many Insurers Improved Patient Care, Survey Finds
Many U.S. health insurers provided better medical care to their patients in 2004, but more consumers are enrolling in types of plans that do not make such data public, a survey released Monday found.
A privately held insurer, Harvard Pilgrim Health Care, provided the best healthcare coverage in the United States, according to the survey by the National Committee for Quality Assurance, a privately funded nonprofit group.
Several Cigna Corp. and Aetna Inc. plans dotted the survey’s top 50 commercial pickings. Other top plans included Tufts Health Plan, ConnectiCare and Anthem Blue Cross and Blue Shield.
The best plans serving enrollees of Medicare or Medicaid -- the nation’s insurance programs for the elderly, disabled and poor -- varied more widely.
The Independent Health Assn. of New York was the only one to earn a top slot for both its commercial and government-related coverage.
The quality assurance group based its rankings on the type of care patients received, especially for chronic diseases such as diabetes and hypertension, as well as patient satisfaction. The Washington-based group used data culled from patient medical records, doctors’ claims and patient surveys.
Overall, more commercially insured patients are being treated for high cholesterol, asthma and high blood pressure, among other conditions. For example, in 2004, 68% of patients were treated for high cholesterol after a heart attack, compared with 65.1% the previous year.
The one notable exception was in the percentage of patients receiving breast cancer screening, which dropped to 73.4% last year compared with 75.3% in 2003.
Advisory groups disagree on whether women need mammograms -- a scan that detects cancerous cells -- every year after a certain age, or can safely receive them every other year.
“I do think it reflects some confusion on the part of women of what the real benefits are,” quality assurance group President Margaret O’Kane said.
The survey was conducted in collaboration with U.S. News and World Report.
Most of the plans reviewed were health maintenance organization or point-of-service plans that regularly volunteer their patient care data.
Other types of plans, including preferred provider organizations or those with high deductibles, generally do not report such data, the group’s researchers said. More patients are signing up for them, making information on quality more scarce, they said.
About 582 plans reported data, representing 21.5% of the health insurance industry, or about 64.5 million patients.
More than half of plans that do not report data are Medicaid plans, the group said.
The quality assurance group urged more health insurers to provide information and said employers and other buyers should demand it. But the group stopped short of calling for mandatory reporting.
“The new mantra for healthcare purchasers needs to be ‘show us your data.’ Why trust your family’s health to an organization that operated behind closed doors?” O’Kane said.
Medicare officials are making such reporting mandatory and are using the data as part of a new initiative to pay doctors based on how well they care for patients, not how often.
