Managed Care in New York State Gets High Marks for Performance and Customer Satisfaction

Medicaid Plans Outperform Commercial Health Insurance in Childhood Immunizations, Lead Poisoning

ALBANY, N.Y. (October 28, 2010) – Managed care plans in New York State continue to provide high quality services to consumers in the areas of preventive care for children, women's health, and care for individuals with chronic diseases, according to a report issued today by the New York State Department of Health (DOH).

The Quality Assurance Reporting Requirement (QARR) report measures the 2009 performance of managed care plans and includes information on specific areas of public health, counties and populations served by individual plans, and customer satisfaction. The annual report is compiled by DOH in collaboration with managed care organizations and providers.

"Managed care plans in New York State provide quality services to millions of New Yorkers, and the QARR report tracks their performances in a number of critical areas," said State Health Commissioner Richard F. Daines, M.D. "The report shows continued improvements in meeting consumer needs and that member satisfaction is high. I encourage individuals and families to review this information so they can make informed health care decisions."

"The strong performances of Medicaid, Child Health Plus and commercial health plans in New York often exceed national averages and provide access to high-quality health care," said Donna Frescatore, Director of New York Medicaid and DOH's Office of Health Insurance Programs. "Increased access to preventive screenings and effective management of chronic illnesses are consistent with the goals of federal health reform and will reduce health care costs associated with avoidable hospitalizations."

Findings of the QARR report indicate that more children are being fully immunized against diseases, more women are receiving screenings to protect their reproductive health, and a greater number of people living with diabetes are receiving recommended services and experiencing improved outcomes.

Other highlights of the report include:

Preventive Care for Children

Receiving appropriate immunizations and having a blood test to check for lead poisoning are fundamental preventive care services for children. A child who is "fully immunized" will have received vaccines for Diphtheria/Tetanus/Pertussis (DTaP), Polio, Measles/Mumps/Rubella (MMR), H Influenza B (Hib), hepatitis B, and Varicella.

  • 73 percent of children in Medicaid managed care plans and 68 percent enrolled in commercial health insurance were fully immunized by the age of two. The improvement in Medicaid immunization rates over the past five years has resulted in nearly 16,000 additional children being fully immunized.
  • 90 percent of children in Medicaid managed care plans and 78 percent of children enrolled in commercial health insurance have received blood tests for lead poisoning at least once before their second birthday.

Weight Assessment and Counseling for Nutrition and Physical Activity is a measure used to evaluate preventive care to promote healthy weight. It includes a calculation of a child's Body Mass Index (BMI) percentile and counseling about healthy eating and the proper level of physical activity for children between the ages of three and 17.

  • 55 percent of children enrolled in Child Health Plus received a weight assessment, an increase of 8 percent from the previous year. Rates for nutrition and physical activity counseling also rose.

Women's Health

It is recommended that sexually active women have at least one test for Chlamydia annually to prevent long-term complications from pelvic inflammatory disease and infertility.

  • Since 2001, the rates for Chlamydia testing have nearly doubled for women in Medicaid managed care, rising from 37 percent in 2001 to 67 percent in 2009, which equates to nearly 29,000 more women being tested at least once a year. The rate for women enrolled in commercial health insurance rose from 27 percent to 56 percent in the same period.

Care for People with Chronic Diseases - Diabetes

Maintaining recommended levels of glycosolated hemoglobin (blood sugar or HbA1c) is an essential component of diabetes management. The rate of poor control reflects the percentage of diabetics with blood sugar levels above the recommended levels. A lower percentage reflects better health.

  • The rate of poor control for Medicaid managed care patients with diabetes has declined from 52 percent in 2000 to 33 percent in 2009, which translates to approximately 26,500 fewer Medicaid recipients with poorly controlled blood sugars. The 2009 rate of poor control for enrollees in commercial health insurance is 28 percent.

Improved Care in Public Programs

The statewide performance rates continue to increase for populations in both Medicaid and commercial health insurance and routinely meet or exceed the national average. Medicaid rates of performance have been lower than commercial rates for most measures, but the gap in performance continues to diminish in numerous areas of care, including preventive care, prenatal care, women's health and care for people with chronic conditions. For example, the gap in the rates of asthma medication usage between commercial and Medicaid plans decreased from 6 percent in 2003 to 2 percent in 2009.

The results of the QARR report – the 16th annual report issued by DOH – are available by organization and grouped into six regions: Central, Hudson Valley, Long Island, New York City, Northeast, and Western. The report is available on DOH's Web site at: http://www.nyhealth.gov/health_care/managed_care/reports/eqarr/2010