Quality in Maryland Commercial Health Benefit Plans has improved over time, but performance trails national and regional averages

Written by on February 23, 2012 in Uncategorized - No comments

BALTIMORE (February 1, 2012) — The Maryland Health Care Commission (MHCC) has released its 2011 Comprehensive Performance Report: Commercial HMO, POS, and PPO Health Benefit Plans in Maryland, which provides quality and performance information that enables users to compare health plans on key measures regarding health care delivery and member satisfaction. Information in the report is primarily used by large employers and health care policy makers.

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Maryland’s HMO and POS plans have demonstrated improved performance over time. Of the 13 clinical measures and indicators for which there is 10 years of data, 12 measures show clear trends of improvement since 2000, and only one measure, Breast Cancer Screening, shows a three percent performance decline. Four measures show continuous and marked improvement from 2000 to 2011, including Childhood Immunization, which improved from 57 percent to 81 percent, Use of Appropriate Medications for People with Asthma, which improved from 57 percent to 94 percent, Diabetes Care Medical Attention for Diabetic Nephropathy, which increased from 36 percent to 83 percent, and Cholesterol Management LDL-C Screening, which increased from 66 percent to 87 percent.

Although the improvement was not consistent, two additional measures show marked improvement, Diabetes Care LDL-C Screening and Controlling High Blood Pressure. Performance results over time for PPO plans were not included in the data comparison because voluntary reporting of PPO data did not begin until 2008. Performance trend data will be included in future reports.

The 2011 report contains information on 52 performance measures grouped into five domains of related information: Screening and Preventive Care (18 measures), Treatment and Management of Care (14 measures), Satisfaction with the Experience of Care (9 measures), Use of Service (8 measures), and Health Benefit Plan Descriptive Information (3 measures). Maryland’s HMOs, POSs and PPOs, on average, are performing in the middle of the pack when compared to the region and nation, with more performance variation among plans on primary and chronic care measures and less variation on behavioral health and member satisfaction measures. Health benefit plans are near or slightly above regional and national averages for many primary care and behavioral health measures. Member satisfaction is below both regional and national averages on all nine measures except for the health promotion and education, which was equivalent to the region.

“It is obvious that health benefit plans need to improve their performance, so the hard work begins. Healthcare reform has provided an opportunity to rethink our health strategy in Maryland. Overall, a healthy Maryland must not be the responsibility of health benefit plans alone, but the responsibility of plan members, employers, policy makers and communities”, said Ben Steffen, Acting Executive Director of the Maryland Health Care Commission.

For additional information about the Health Benefit Plan Performance Report, contact Scharmaine Robinson, Chief, Health Benefit Plan Quality & Performance, 410-764-3483 or srobinson@mhcc.state.md.us.

from the Maryland Department of Health and Mental Hygiene

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