The State of Health Care Quality Report

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NCQA produces the State of Health Care Quality Report every year to focus on major quality issues the U.S. faces and to support the spread of evidence-based care. This report documents performance trends over time, tracks variation in care and recommends quality improvements.

The State of Health Care Quality Report 2015 synthesizes data collected throughout 2014 by NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®), health care’s most widely used performance improvement tool. The report summarizes the quality and consumer satisfaction results of health plans covering more than 171 million people, or 54 percent of the U.S. population.

A Webinar discussing the report toook place on Wednesday, October 21, at 2 p.m. ET. The report will be available following the Webinar. 

The celebration of NCQA’s 25th anniversary in 2015 has prompted a new direction for the 2015 edition of the State of Health Care Quality Report. Rather than focus on recent changes in health plans’ aggregate quality, this year’s report takes a broader view of key drivers affecting quality:

  • Progress on Medicare Star Measures: Star measures that are also HEDIS measures show some of the strongest improvement in this year’s report. On some measures, Medicare performance has overtaken that of Commercial plans.
  • Statistically Significant Trends: There’s good news on obesity and mixed results for behavioral health. Even when improvement is slow, results are often solid; most measures that haven’t improved significantly are already at high levels of performance.
  • Medicare Access & CHIP Reauthorization Act (MACRA): This recent legislation revises Medicare fee-for-service payment for providers, rewarding value instead of volume. Implications for the quality world could be dramatic. 
  • The Future of Performance Measurement:  The transition from fee-for-service to value-based payment will require more sophisticated metrics. Priorities include moving from measures of process to measures of outcome, incorporating patient experience and patient-reported outcomes, and adapting how we evaluate cost and resource use.