More on quality from November's Newswire

November 1, 2005

Improvements in the state of healthcare quality revealed

According to NCQA's annual State of Health Care Quality, improvements in measures related to high blood pressure and cholesterol control for people with diabetes were made compared with previous statistics. "High blood pressure is very common and, unfortunately, has been poorly controlled," says Earl Steinberg, MD, MPP, president and CEO of Resolution Health, a healthcare data analysis company that provides quality improvement and cost reduction services. "There is tremendous room for improvement on this measure. In addition, high blood pressure is something that the public understands. As a result, when public attention was focused upon this measure in 1999, health plans began efforts to improve blood pressure control-and those efforts are paying off."

NCQA's report shows that huge variations in quality remain commonplace. "Quality gap" is a term NCQA has coined to describe the gap in performance between the national average for a given performance measure and the rate achieved by the top 10% of health plans.

"For example, among the top 10% of health plans, about 68% of people who have had a heart attack have their cholesterol appropriately controlled," says Greg Pawlson, MD, NCQA's executive vice president. "But estimates of the national average for all persons say only about 50% [have it controlled]. So there's an 18 percentage point 'quality gap' between the two. It's important to track these gaps because they really represent the difference between what we could achieve if everyone were getting care in high-quality systems, and what we actually achieve. In this case we know that 68% is a reasonable target because many plans and practices already operate at that level. We also use these gaps to estimate how many lives might be saved if everyone received care through a top performing plan. The numbers are staggering: between 37,000 and 80,000 lives every year."

"Organizations that offer higher quality of care have a substantial advantage over their competitors and not just in terms of marketing and member loyalty. In the long run, it's better value for everyone to deliver high quality care, in terms of quality, cost and efficiency. You don't have to prevent a lot of second heart attacks or strokes to make controlling people's blood pressure and cholesterol a worthwhile investment," Dr. Pawlson says.