A report from the National Committee for Quality Assurance (NCQA) finds that the quality of U.S. healthcare was “virtually stagnant” in 2008, a slowdown after a decade of improvements.
This trend was seen in care provided to people with private insurance coverage as well as in Medicare and Medicaid, the rport says. It also found little to no connection between higher healthcare spending and quality.
“As Congress works to shape a final health reform bill, lawmakers must be certain that the legislation includes significant provisions to improve the quality and efficiency of care,” said NCQA President Margaret E. O’Kane. “This includes requiring quality reporting by all health plans and providers, not just those who do so voluntarily today.”
Improving healthcare quality would have significant benefits beyond the healthcare system, according to the NCQA. The association estimates that if all health plans performed at the level of the top 10 percent of plans, the nation would avoid as many as 115,000 deaths and save at least $12 billion in medical costs and lost productivity every year.
The study noted a few improvements – in areas such as keeping heart attack patients on life-saving beta blocker drugs and delivering flu shots – but identified declines in several measures related to mental health, diabetes care, the overuse of imaging for low back pain and breast cancer screening.
Key areas of care have seen little progress in several years, according to the study. For example:
- 46.4 percent of people taking anti-depressant drugs are monitored by their physicians.
- 34.1 percent of children prescribed medications for attention deficit hyperactivity disorder (ADHD) are seeing a doctor for follow-up care;
- Half of patients previously hospitalized for mental illness see a physician for a follow-up visit;
- 45.3 percent of people are receiving colon cancer screening at the appropriate age; and
- 42.6 percent of patients with alcohol or drug dependency are entering into treatment.
“Hundreds of health plans have made the commitment to measure and report on the quality of care provided to their members," said O'Kane. "Those plans have made remarkable progress in improving care. But they cannot do this alone. It is time for all plans and providers to step up to the plate and do the right thing for their members."
NCQA’s 2009 State of Healthcare Quality Report examines quality data submitted by 979 health plans across the country that collectively cover 116 million Americans – a 9 percent increase over 2008. Plans submit data using NCQA’s Healthcare Effectiveness Data and Information Set, or HEDIS, a set of measures that assess how often patients receive care that conforms to evidence-based guidelines.