Managed Care Plans Continue to Improve

Albany, NY (September 19, 2007) – More people enrolled in managed care plans in New York are receiving the preventive and chronic-disease services that are essential to good health, according to a new study from the State Department of Health.

The 13th annual managed care performance report compiles 2006 performance information collected from more than 30 health plans certified by the Department to serve commercially and publicly insured (Medicaid, Child Health Plus and Family Health Plus) managed care members. Performance is measured across preventive health, chronic disease and member satisfaction measures.

The electronic version of the report, known as eQARR, is available at www.health.ny.gov/health_care/managed_care/reports/eqarr/2007/, and provides information to help consumers make choices about their health coverage.

Health Commissioner Richard F. Daines, M.D., said, "The increase in health plan performance that we are witnessing translates into improved health care and thereby healthier New Yorkers. Even in areas where rates of performance are not yet where we would like to see them, we still are encouraged by the upward trends. We will continue to work with plans across the state to improve care and patient satisfaction."

"Improving quality has always been a priority for managed care plans and the annual performance report shows plans are doing just that," said Paul Macielak, President and Chief Executive Officer of the New York Health Plan Association. "They also show us areas for DOH and the plans to focus efforts for further improvements in the care delivered to New Yorkers."

"We are proud of the high quality care our Medicaid, Family Health Plus and Child Health Plus members receive from our plans and our provider partners," said Robert Thompson, Chairman of the New York State Coalition of Prepaid Health Services Plans, a trade association representing 12 provider-sponsored Medicaid managed care plans. "We are particularly pleased to have the hard data to show that the quality of care our public health insurance plans provide is on par with that of commercial insurance. Our plans and provider partners have employed innovative approaches that have resulted in significant improvements in the quality and accessibility of health care, and these innovations will continue to result in quality improvements going forward."

Of particular note are the improvements that plans have made since the 2000 reporting year, including:

Prenatal care:

In 2000, 86 percent of commercially insured pregnant women and 74 percent of Medicaid-insured pregnant women received prenatal care in the first trimester or within 42 days of their enrollment with the plan. By 2006, those rates increased to 92 percent for commercial and 86 percent for Medicaid.

In 2000, 73 percent of commercially insured women who had recently given birth received a postpartum visit within the recommended timeframe. For Medicaid, the rate was 61 percent. By 2006, the rate for commercial was 76 percent and for Medicaid, 70 percent.

Children's Health:

In 2000, 91 percent of commercially insured and 82 percent of Medicaid-insured 12- to 21-year-olds had a visit with a primary care physician. By 2006 the rate for commercial had increased to 96 percent and the rate for Medicaid rose to 91 percent.

Women's Health:

In 2000, 80 percent of commercially insured women had been screened for cervical cancer within the past three years, while 71 percent of Medicaid-insured women obtained this service. In 2006, the rates rose to 82 percent and 74 percent, respectively.

Chronic Disease:

In 2000, 58 percent of commercially insured and 49 percent of Medicaid-insured adult diabetics had dilated eye exams. In 2006 those rates rose to 59 and 57 percent, respectively. In addition, diabetics who had an Hemoglobin A1c test increased from 79 percent in 2000 to 88 percent in 2006 for commercially insured and from 76 percent to 86 percent for Medicaid-insured.

Mental Health:

In 2000, 75 percent of commercially insured persons hospitalized for a mental illness were seen within 30 days by a mental-health practitioner. The rate for Medicaid was 63 percent. By 2006, the rate for commercial increased to 78 percent and to 76 percent for Medicaid.

Satisfaction with Care:

In 2000, the rate of members who rated their health plan as an 8, 9, or 10 on a scale of 1-10 was 63 percent for commercial members and 67 percent for Medicaid members. In the most recent data, 62 percent of commercial members and 75 percent of Medicaid members indicate high levels of satisfaction with their plans. In addition, customer service support of members improved from 2000, when 61 percent of commercial and 65 percent of Medicaid members said they had no problem with member services. In 2006, those rates improved to 80 percent and 75 percent, respectively.