ACAAI and Health Benchmarks Partner to Assess the Utility of the HEDIS Asthma Metric.

WOODLAND HILLS, Calif. -- Health Benchmarks(R) and leading asthma experts identified key areas for improvement in asthma metric widely used to measure health plan performance

A recent study published in Annals of Asthma, Allergy, and Immunology evaluated the effectiveness of a Health Plan Employer Data and Information Set (HEDIS(R)) asthma metric to predict asthma-related hospitalizations and ER visits in a managed care population. The study identified several important areas for improvement in the measure's methodology and design. The study was conducted and co-authored by Health Benchmarks(R) (HBI) in collaboration with the American College of Asthma, Allergy, and Immunology.

"The results of our study support previous literature showing that inhaled corticosteroids are preferred therapy for treating persistent asthma. Patients taking inhaled corticosteroids had significantly lower likelihood of ER visits or hospitalizations due to asthma," said ACAAI past-president and study co-author, Michael S. Blaiss, M.D. "The superiority of inhaled corticosteroids should be reflected in the HEDIS measure to adequately represent the most recent clinical evidence."

Asthma is a severe chronic illness affecting over 15 million Americans with over $11 billion in annual costs. Despite the publication of asthma treatment guidelines over one decade ago, there is considerable evidence of significant variation in asthma management. The HEDIS measures are developed and maintained by the National Committee for Quality Assurance (NCQA) to ascertain health plan performance across a range of criteria and to permit unbiased plan-to-plan comparisons. Today, a majority of Fortune 100 companies will contract only with NCQA-accredited health plans and almost three-quarters of the nation's largest employers use HEDIS information to evaluate and set performance guarantees for health plans serving their employees.

To evaluate the current HEDIS asthma measure, HBI conducted a retrospective analysis of administrative claims data for patients who met HEDIS criteria for persistent asthma in 1999. The study evaluated the association between long-term controller therapy for persistent asthma, adherence to therapy, and asthma-related hospitalizations or ED visits. The findings, detailed in Annals of Asthma, Allergy, and Immunology, include a significantly higher risk of ER visit or hospitalization for patients with low adherence to controller therapy. Patients receiving a high days-supply of inhaled corticosteroids, the recommended long-term therapy for persistent asthma, had the lowest risk of ER visit or hospitalization. Over 25% of the patients identified by the HEDIS criteria as persistent asthmatics in 1999 did not use any asthma medication in the subsequent year.

"As currently designed, the HEDIS asthma measure identifies more than 25% of persons who lack clear evidence of persistent asthma in the subsequent year," said Antonio Legorreta, M.D., M.P.H., President and CEO of HBI and study co-author. "This study suggests that refinements to the HEDIS measure methodology for identifying patients with persistent asthma may be needed. In addition, refining the specifications to include a measure of asthma medication adherence may improve the utility of the HEDIS asthma measure to predict asthma-related outcomes for persons with persistent asthma."

Health Benchmarks(R) delivers real-world health outcomes research, analysis, and consulting services to pharmaceutical companies and health plans and is a pioneer in the development of health provider pay for performance solutions for managed care organizations. For more information about Health Benchmarks, please visit www.healthbenchmarks.com or call 1-800-465-6575.