High and Low Performers: How 2015 Measured Up in the State of Health Care Quality

October 20, 2015 · NCQA

It’s an annual rite of passage. October brings turning leaves, hayrides and the release of NCQA’s annual State of Health Care Quality Report. While all of this may seem routine, there are a few key points to share from this year’s report.

Only 58.9% percent of children in Medicaid plans go to six or more well-child visits a year. As the child gets older, the number decreases: only 50 percent of adolescents go to at least one comprehensive well-care visit.

From a more positive standpoint, nearly 84 percent of people with Asthma enrolled in Medicaid plans use the appropriate medications.

These statistics prove the quality of health care fluctuates depending on the type of care you seek.

The State of Health Care Quality report takes a detailed look at the state of our nation’s health care, how much it has evolved and how far it still needs to go.

NCQA uses HEDIS measures to examine whether health care providers follow needed steps to deliver high quality care. These measures also help pinpoint where health insurance plans succeed in providing coverage and where they need to improve.

The report signals a time for examination, and an opportunity to identify certain trends. Some highlights from the report include:

• Medicare Star Measures are heading in the right direction. Medicare Star measures that are also HEDIS measures are some of the strongest performers, with some surpassing the performance of Commercial plans.
• Some trends are statistically significant. There is good news on obesity measures, mixed results for behavioral health and many measures that remain at high levels of performance.
• A bright light for quality improvement. The implementation of the Medicare Access & CHIP Reauthorization Act (MACRA) in 2015 will help clinicians focus on quality improvement, by tying payment to value of care, rather than volume of procedures.
• A look to the future. MACRA positions policymakers and clinicians to incorporate patient experience into their vision for quality improvement.

It is only fitting that our report is released during National Health Care Quality Week. As NCQA looks forward, so many in the health care universe are becoming increasingly focused on the value of care rather than the volume of procedures. We want this report to serve as a guidepost in identifying strengths and weaknesses. We want it to assist them in improving the quality of care.

You can learn more about the report’s findings in a full online briefing. Learn more.