DOH Releases 2001 Report on Managed Care Performance

Report Helps Consumers and Provides Improved Health Care in New York State

Albany, July 11, 2002 - State Health Commissioner Antonia C. Novello, M.D., M.P.H., Dr.P.H. today released the seventh Annual Report on Managed Care Performance in New York State, showing that health plans continue to improve the quality of care provided to New Yorkers through Medicaid Managed Care, Child Health Plus and private commercial insurance.

"The improvements found in the care provided by Medicaid Managed Care Plans, Child Health Plus and commercial insurance plans are a clear indication that Governor Pataki is making sure that each and every New Yorker has access to the best health care in the nation," Dr. Novello said. "Equipped with the information in this report, consumers can make informed decisions about the health plan they choose and the health care delivery they expect and are entitled to. We are able to offer consumers a comprehensive look at the state of managed care in New York, because of the continued quality of the information provided by health plans."

The 2001 report shows that New Yorkers in these plans continue to receive preventive health care at rates above the national average. The New York State QARR (Quality Assurance Reporting Requirements) Report is the most comprehensive report card for managed care in the nation. Produced by the State Health Department in collaboration with 49 managed care organizations and managed care providers, the report provides information that can be used by consumers and purchasers to weigh how well health plans are providing services. The report is also used as a quality improvement tool by health plans in New York State. The 2001 report is based on calendar year 2000 quality data.

The information gathered in the report and the related findings will be used to help achieve Governor Pataki's health goals for New York which include: reducing the burden of asthma attacks among children; increasing immunizations for two-year olds; significantly reducing teenage smoking; and eliminating perinatal transmission of HIV disease.

The Health Department also uses the QARR Report data to work with plans and providers to enhance the health outcomes of managed care enrollees through performance feedback, quality improvement programs, technical assistance and highlighting and implementing best practices.

The report findings, when combined with information from other sources such as perinatal records, adolescent surveys, inpatient hospital data (SPARCS) and the new emergency room registry are used to further improve health care delivery in New York State.

2001 QARR Report Findings

The 2001 QARR Report includes quality measures on prenatal and postpartum care, child and adolescent care, and adult preventative and chronic disease. In addition, the report includes measures of access to care, descriptive plan statistics and consumer's assessment of their healthcare experience. The report is based on the Quality Assurance Reporting Requirements (QARR) data and represents commercial, Medicaid and Child Health Plus enrollee services. This year's report reflects continued improvement in a number of key measures. Highlights include:

Commercial Insurance Plans:

  • 81 percent of enrollees indicated they received health plan services quickly.
  • 92 percent of enrollees were satisfied with the way their doctors or other health care providers communicated with them.
  • 78 percent of adults who experienced an acute cardiovascular event received increased screening tests, up from 73 percent in 1999 for cholesterol management.
  • 58 percent of adults with hypertension received the proper medical management to control their high blood pressure, a significant increase of 19 percent from 1999. This is higher than the national average of 52 percent.
  • 79 percent of adults between ages 18 and 75, who were diagnosed with diabetes had one or more tests performed to evaluate the control of their disease, a slight increase from 1999. This rate is higher than the national average of 78 percent.
  • 58 percent of adults enrolled in commercial health care plans with diabetes had an eye exam performed, a slight increase from 1999.
  • 61 percent of children with persistent asthma used appropriate medications. This reflects an increase of 13 percent from 1999.
  • 67 percent of adults with persistent asthma used appropriate asthma medications, an increase of ten percent from 1999.
  • 80 percent of women received a Pap Test to screen for cervical cancer, an increase of five percent from 1999.
  • 75 percent of women between the ages of 52 and 69 had a mammogram performed within the last two years.
  • 63 percent of commercial managed care enrollees said that on a scale of 0 to 10, where 0 was the worst health plan possible and 10 is the best health plan possible, they would rate their health plan an eight, nine or 10. This rate is higher than the national average of 59 percent.

Medicaid Managed Care Plans:

  • 77 percent of children aged three to six years old received recommended well-child visits, up eight percent from 1999.
  • 76 percent of Medicaid managed care children ages two years and younger received at least one capillary or venous blood screening test for lead poisoning. This is significantly higher than the federal Government Accounting Office national estimate of 21 percent (based on a study of 15 states' Medicaid programs).
  • 64 percent of children received the appropriate series of immunizations prior to their second birthday; well above the national average of 54 percent.
  • 71 percent of women enrolled in Medicaid managed care received a Pap smear within the last two years. This is well above the national Medicaid benchmark of 60 percent.
  • 87 percent of Medicaid managed care enrollees gave a favorable rating for how well their providers communicate. Eighty-five percent would recommend their health plan to family or friends and 11 percent called or wrote their health plan with a complaint.

Child Health Plus Managed Care Plans:

  • 60 percent of children between the ages of five and 18 with asthma enrolled in Child Health Plus received the appropriate medical care to prevent asthma attacks. This increased from 53 percent in 1999.
  • 62 percent of children enrolled in Child Health Plus received the recommended number of immunizations before their second birthday. This is well above the national average of 54 percent.
  • 68 percent of children enrolled in Child Health Plus received a blood test for lead poisoning by age two. This rate represents a slight increase over 1999.

The annual QARR report is distributed to consumers, libraries, business groups, local health departments and social service agencies, among others. Selected information from the report is also available via eQARR at the Department's Web site at: www.health.ny.gov. The QARR report can be obtained by calling the department at (518) 486-6074 or via the Department's Web site at: www.health.ny.gov.

7/11/02-74 OPA