Spending Big Bucks Doesn’t Equal Better Healthcare

There’s no correlation between health plans’ spending and the quality of care their members receive.  The National Committee for Quality Assurance (NCQA) reports that there is no correlation between the amount health plans spend and the quality of care their members receive. In their annual State of Health Care Quality report, which crunched data from 1,000 health plans insuring 118 million Americans, researchers analyzed spending on the five most costly diseases (diabetes, hypertension and asthma) and found significant variations among the plans.  The biggest spenders don’t always deliver the best care.

Margaret O’Kane, NCQA president, said the study found no clear relation between resource utilization and quality.  She believes that the results point to a need to create a system that spends less and delivers higher quality care.  Additional findings are increases in colorectal cancer screening rates and the ongoing use of beta blockers after heart attacks.  There is room for improvement in the overuse of imaging and antibiotics, as well as helping Medicare patients avoid falling.

In one interesting finding, the researchers learned that vaccination rates for children with private plans fell by nearly four percent over the previous year.  By contrast, vaccination rates rose for children covered by Medicaid in 2009.  One possibility is a popular misconception that links vaccines to autism (blame Oprah partly for this) and has driven some parents away from evidence-based recommendations.  Additionally, there’s been a drop in patient satisfaction with their health plans and physicians.  For example, while 64 percent of members with Medicare plans said they usually or always get the care they need, just 53 percent of respondents with commercial plans felt the same.  This represented a drop from a high of 80 percent in 2005.

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