The State of Health Care Quality 2010

By Clive Riddle, October 15, 2010

NCQA has released their annual quality report:  The State of Health Care Quality 2010: Reform, The Quality Agenda and Resource Use.  The 162 page report provides their annual analysis of quality measures and data from over 1,000 health plans that represent 118 million U.S. members.

This year’s report addresses the concept of Relative Resource Use (RRU): which “indicates how intensively health plans use health care resources (such as physician visits and hospital stays), compared with other plans in the same region, serving similar members. When used alongside quality measures, RRU makes it possible to talk about quality and cost simultaneously. Given the definition of value as the intersection of health plans’ spending (resource use) and their results, RRU reveals the value that plans offer.” NCQA analysis found that “many plans that deliver below-average quality use above-average levels of resources. More care is not always linked to better results.”

Another significant issue raised in the report was that commercial plan 2009 childhood vaccination rates dropped almost four percentage points. NCQA speculates that “a possible cause of this drop is commercial plan parents may refuse vaccines for their children based on the unproven, but increasingly popular, notion that vaccines cause autism. Celebrity activists are outspoken advocates of this view. Interestingly, we see vaccination rates in Medicaid – the program serving the poor – continuing to steadily improve. “  NCQA President Margaret O’Kane tells us “The drop in childhood vaccinations is disturbing because parents are rejecting valuable treatment based on misinformation. All of us in health care need to work together to get better information to the public.”

The report also measures the state of the states, indicating the top ten and bottom ten states for quality, based on four measures for ranking

1. Comprehensive Diabetes Care (ten indicators)
2. Controlling High Blood Pressure (one indicator)
3. Persistence of Beta Blockers After a Heart Attack
4. Cholesterol Management for Patients with Cardiovascular Conditions (two indicators)

States included in the Top Ten, based on mean of rates: CA, IA, MA, MN, ND, NH, OR, SD, VT, WU

States included in the Bottom Ten, based on mean of rates: AK, AL, AR, DE, LA, MS, NC, OK, SC, TN