News & Trends

New HEDIS measures for 2004; President&s New Freedom Commission on Mental Health report; The Commonwealth Fund's report on eroding retiree benefits





The National Committee for Quality Assurance (NCQA) continued its efforts to make the Health Plan Employer Data and Information Set (HEDIS) more relevant to consumers with three new measures for 2004. Service performance measures will track the percentage of claims paid in 30 days and calls answered within 30 seconds, as well as the percentage of frustrated callers who hang up before they hear a human voice.

Seven other new measures for next year target major public health issues. An antibiotics measure, for instance, focuses on appropriate prescribing and use to slow down proliferation of drug-resistant strains, while new chemical dependency measures track both initial and follow-up treatment.

Also on tap for 2004: measures of screening for colorectal cancer and treatment of urinary incontinence and osteoporosis, two of the most prevalent and costly conditions among older adults.

Ninety-five percent of employers offer some form of health promotion program, up from 88 percent in 1995, says a new study from Hewitt Associates. The study also says 75 percent of employers offer or plan to offer disease/condition management programs in 2003; 40 percent of employers used financial incentives/disincentives in 2002 (compared to 14 percent in 1993) to encourage behavior modifications; and nearly one in three employers are offering health risk appraisals.


Mental health care in the U.S. needs major restructuring, says the President's New Freedom Commission on Mental Health. Its recent report emphasizes community services over institutional care by calling for treatment of the mentally ill to go past medication and include helping people find jobs, make friends and live more meaningful lives. The Commission's first goal, however, is to help Americans understand that mental health is essential to overall health.

With 5 to 7 percent of American adults having a serious mental illness (and 5 to 9 percent of children having a serious emotional disturbance), the report "Achieving the Promise: Transforming Mental Health Care in America," focused on two key points: First, services and treatments must be consumer and family centered — offering meaningful choices of treatment and providers not oriented to the requirements of bureaucracies. Moreover, it emphasizes coordination of care at the state rather than the federal level. Secondly, the Commission wants care to do more than manage symptoms. Recognizing that mental illness is the leading cause of disability, the Commission thinks treatment should focus on increasing the patient's ability to cope with life's challenges and building resilience.

The report doesn't recommend increasing spending on mental health, but rather a more coordinated and efficient use of current funding that would reduce the 15 to 20 years it currently takes for major treatment advances to become common practice.

To reduce the risk of spreading infections during health care treatments, all hospitals accredited by the Joint Commission on Accreditation of Healthcare Organizations must comply with CDC hand-washing practices starting in January. Providers will also be required to report all cases of mortality or major issues connected with a health care-acquired infection. This directive joins the previous six "National Patient Safety Goals" established by the JCAHO in 2002.



A new study from The Commonwealth Fund confirms a sharp drop in employer-sponsored health insurance for new retirees with special emphasis on eliminating prescription drug coverage. In 2000, 39 percent of people age 65 to 69 received health insurance from an employer. That's down from 46 percent back in 1996. The percentage of new retirees who got drug coverage dropped from 40 percent in 1996 to 35 percent in 2000. Coverage for retirees age 70 and over has remained relatively stable.

The study also found that among new retirees, coverage of men has dropped the most rapidly. The share of men 65 to 69 getting benefits from their own retirement polices dropped 26 percent between 1996 and 2000, with the rate of decline for men three times that of the rate for women.

Health care consumers value cost information over quality of care info, according to a new study by The Dierginer Research Group. Treatment information still leads overall with 78 percent of workers researching diagnoses and drugs. Cost and quality of care are catching up fast, though, with 69 percent needing cost information and 65 percent hospital quality information, while 57 percent indicate physician quality is useful in making health care decisions.


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Aug. 1, 2003;21.