HMO CARE LEVELS DIFFERENT AROUND U.S., STUDY SHOWS; PANEL SAYS LIVES COULD BE SAVED.
The quality of HMOs varies widely across the country on such key measures as how doctors screen patients for breast cancer, treat heart disease and immunize children, according to the most comprehensive rating ever done of managed care.
Tens of thousands of lives would be saved if every HMO performed as well as the best do, said the National Committee for Quality Assurance, which accredits HMOs and released its annual survey Wednesday.
``The range of health plan performance across the country, and even within regions, is striking,'' said Margaret O'Kane, NCQA president.
For instance, some health plans screened 90 percent of women at risk for breast cancer in 1996; others screened just 30 percent.
In New England, the average health plan gave 81 percent of children all the immunization shots they needed. But in South Central states like Alabama and Kentucky, the average was just 58.5 percent.
The report does not give composite ratings for each health plan or attempt to judge which plans are the best overall. Instead, it identifies dozens of procedures and standards, and ranks performance in each.
It includes 329 health maintenance organizations and other managed care plans, which voluntarily supplied information on more than 50 measures. These plans cover about 37 million of the 58 million Americans enrolled in managed care.
The ratings are not readily available to consumers. The data are meant for employers - mostly large employers - who shop for health plans.
All sides agree that the reports can improve health care by forcing HMOs to examine and improve on their weaknesses.
``Even though the report may appear to be negative, it has a positive side,'' said Dr. Emil Miskovsky, medical director for Cigna Healthcare of St. Louis, which rated below average for breast cancer screenings and eye exams for diabetics.
``You recognize that's an area where you put a little more emphasis and resources upon.''
The National Committee on Quality Assurance's Quality Compass shows a wide disparity among health maintenance organizations and other managed care plans on a variety of quality measures. Highlights:
Advising smokers to quit
National average: Doctors in HMOs advised 61 percent of smokers to quit.
Top plan: Advised 85 percent of smokers to quit.
Bottom plan: Advised 30 percent to quit.
If all plans were top performers: Nearly 26,000 people would quit smoking each year.
Beta-blocker treatment after a heart attack
National average: 61.9 percent of heart-attack survivors were prescribed these drugs.
Top plan: Prescribed to 100 percent.
Bottom plan: Prescribed to 15 percent.
If all plans were top performers: 1,600 cardiac deaths would be prevented each year.
Breast cancer screening
National average: Gave mammograms to 70.4 percent of women ages 52 to 69.
Top plan: Gave mammograms to 90 percent.
Bottom plan: Gave them to 30 percent.
If all plans were top performers: 1,200 more breast cancer cases would be detected each year, saving 1,800 years of life.
BOX: SURVEY SAYS (see text)
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|Publication:||Daily News (Los Angeles, CA)|
|Article Type:||Statistical Data Included|
|Date:||Oct 2, 1997|
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