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Home / News & IndustryManaged Care Insight and Analysis
Updated: February 9, 2010
U.S. Health Care Quality: The Good, The Bad, The Ugly

The quality of U.S. healthcare was virtually stagnant in 2008, according to a report by the National Committee for Quality Assurance (NCQA). This represented the first setback in quality after a decade of improvements. NCQA is a private, non-profit organization dedicated to improving healthcare quality.

The trend of stagnant healthcare was across-the-board for people covered by private insurance, HMOs, Medicare and Medicaid.

The report found no link between higher healthcare spending and quality and also that low performing plans cost up to $12 billion annually in unnecessary care and lost productivity.

NCQA President Margaret E. O’Kane said one way to improve the quality and efficiency of care is to require quality reporting by all health plans and providers, "not just those who do so voluntarily today."

NCQA’s 2009 State of Health Care Quality Report poured through quality data submitted by 979 health plans, covering 116 million Americans. The plans submit data using NCQA’s Healthcare Effectiveness Data and Information, a set of measures assessing how often patients receive care that conforms to evidence-based guidelines.

The Report Did Uncover Some Good News

More providers kept more heart attack patients on life-saving beta blocker drugs. They delivered flu shots and registered near universal high-quality care for most of the 30 million Americans with asthma. Gains were made in helping Medicaid beneficiaries stop smoking, particularly important as 1 in 3 Medicaid beneficiaries in health plans are smokers.

There were declines in several measures related to diabetes care, the overuse of imaging for low-back pain and breast cancer screening.

The findings revealed that less than half the children and adults, or individuals previously hospitalized for mental illness, seldom see a doctor or are monitored by their doctor. Less than half of all Americans are receiving colon cancer screenings or entering treatment programs for drug and alcohol dependence.

O’Kane called on Congress to improve care, expand quality measurement to the 60 percent of Americans not currently covered by accountable health plans and revitalize the nation’s primary care system.

Address: National Committee for Quality Assurance, 1100 13th Street NW, Suite 1000, Washington DC 20005; (202) 955-3500, www.ncqa.org.


  This article was taken from:
Pay-For-Performance Reporter

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