Consumer Reports releases rankings of health plans

In partnership with the National Committee for Quality Assurance, Consumer Reports has released a ranking of 99 Medicaid managed care plans in the United States that chose to publicly release quality standards (Source: “Medicaid health plan rankings from the NCQA,” Consumer Reports, Oct. 3, 2011) 

The rankings are based on 2010 performance data focused on member satisfaction, preventive services offered and delivery of treatment for common conditions. Points also were given for NCQA accreditation, but not for accreditation from other organizations.

When looking at the rankings, it is important to consider the following:

• Participation in the rankings is voluntary (5 of 7 Medicaid managed care plans in Ohio participated: UnitedHealthcare Community Plan and Amerigroup Ohio did not). 
  
  “All the health plans in these rankings are exemplary,” said NCQA President Margaret E. O’Kane in a press release announcing the rankings. “First, they measure their quality in painstaking ways that help them improve and that make comparing plans possible. Then they take the extra step of revealing their results for the world to see—a true public service.”
• Plans in some states could rank higher because their state has adopted more uniform quality standards that more closely align with the ones used by NCQA in the rankings. Michigan, for example, has adopted a series of the NCQA’s Healthcare Effectiveness and Information Set, or HEDIS, standards for all of its managed care plans. Ohio, which in the past has used more homegrown, individualized standards, has recently taken similar steps to adopt uniform quality standards, which would be reflected in future rankings.

According to data included in HPIO’s Ohio Medicaid Basics 2011, spending on managed care plans accounts for 33.9% of the more than $15 billion the state annually spends on Medicaid.

"I am very disappointed in the performance of Ohio's Medicaid managed care plans in the Consumer Report/NCQA rankings,” said state Medicaid Director John McCarthy in a statement. “I believe our managed care plans can do better.

“As we strive to improve health outcomes, the Office of Health Plans has created a new Medicaid quality strategy that will refocus the quality efforts of our managed care plans,” he added. “This is revolutionary in the operations of Ohio's Medicaid managed care plans because we are changing the way we measure and pay for improving health care outcomes. To make this happen, we are writing new contracts that will reward plans for making real improvements in the health outcomes of individuals enrolled in the Medicaid program."

Consumer Reports last week also released an online tool that uses NCQA quality scores for 830 private, Medicare and Medicaid health plans andenables consumers to compare plans by designating a state and plan category (private HMO, private PPO, Medicare HMO, Medicare PPO and Medicaid HMO).
 
[Full disclosure: CareSource Foundation provides financial support to the Health Policy Institute of Ohio.]