NCQA and New York State Health Foundation Give Medicaid, State Health Plans High Marks in Health Care Quality

ALBANY, N.Y. (April, 04 2013) – A recent forum hosted by the National Committee on Quality Assurance (NCQA) and the New York State Health Foundation recognized New York State for the high quality of health care provided in the State, including the excellent performance of Medicaid health care plans.

The NQCA issues a national "State of Health Care Quality Report" each year to highlight specific health plan performance data on key measures such as chronic condition management; prevention measures such as weight assessments and cancer screenings; specific measures targeted to protecting the health of children and older adults; and wellness. This independent analysis identifies health care quality trends and tracks performance of health plans, and overall results for states.

"New York State has made major strides to transform and improve our health care, including groundbreaking innovations in the redesign of our Medicaid program," State Health Commissioner Nirav R. Shah, M.D., M.P.H., said. "We continue to explore new strategies to provide more efficient, high quality care, improve health outcomes, and address key public health challenges, and as this report notes, these efforts are producing positive results."

In 2011, Governor Cuomo created the Medicaid Redesign Team (MRT) to "conduct a fundamental restructuring of [New York's] Medicaid program to achieve measurable improvement in health outcomes, sustainable cost control and a more efficient administrative structure." One of the key goals of MRT was to transition Medicaid beneficiaries from Fee for Service to managed care, recognizing the health quality benefits that can be achieved through a program of care management for all.

The Quality Report analysis demonstrates that care management is working well in New York State. It improves health care quality, lowers health care costs, and has been welcomed by Medicaid enrollees. For example, a separate analysis conducted recently indicated that the rate of customer satisfaction for enrollees in New York's Managed Long Term Care program is 90 percent.

In addition to improvement in Medicaid plans, NCQA recognized New York for:

  • Having the most NQCA-recognized Patient-Centered Medical Homes (PCMHs) of any state -- and twice the number of PCMH sites and clinicians of the number 2 state. Overall, 40 percent of Medicaid patients have a PCMH, which improves the delivery of primary care, including increased care coordination and access.
  • Incentives to improve care for individuals who received both Medicaid and Medicare (dual eligibles);
  • Increased rates of childhood immunization, blood pressure control as part of diabetes management; colorectal cancer screening; assistance to help people quit smoking; and
  • Creation of a state-run Health Benefit Exchange to help individuals, families and small businesses obtain affordable health insurance, which is expected to further improve health care services and quality.

To compile the annual Health Care Quality Report, NCQA used the Healthcare Effectiveness Data and Information Set (HEDIS), which measures performance on important dimensions of care and service. Based on a high number of health care plans collecting HEDIS data, it can be used as a tool to compare the performance of health plans on an "apples-to-apples" basis.

To view the PowerPoint presentation on New York's performance that was shown at the forum, visit: