+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

National quality monitoring of Medicare health plans: the relationship between enrollees' reports and the quality of clinical care



National quality monitoring of Medicare health plans: the relationship between enrollees' reports and the quality of clinical care



Medical Care 39(12): 1313-1325



The clinical quality of health plans varies. The associations between different measures of health plan quality are incompletely understood. To assess the relationships between enrollee reports on the quality of health plans as measured by the Consumer Assessment of Health Plans Study (CAHPS 2.0) survey and the clinical quality of care measured by the Medicare Health Plan Employer Data and Information Set (HEDIS). Observational cohort study. National sample of 233 Medicare health plans that reported data using the CAHPS 2.0 survey and Medicare HEDIS during 1998. Five composite measures and four ratings derived from the CAHPS survey and six measures of clinical quality from Medicare HEDIS. Two composite measures ("getting needed care" and "health plan information and customer service") were significantly associated with most of the HEDIS clinical quality measures. The proportion of enrollees having a personal doctor was also significantly associated with rates of mammography, eye exams for diabetics, beta-blocker use after myocardial infarction, and follow-up after mental health hospitalization. Enrollees' ratings of health plan care were less consistently associated with HEDIS performance. In multivariable analyses, the measure of health plan communication ("health plan information and customer service") was the most consistent predictor of HEDIS performance. The pattern of associations we observed among some of the measures suggests that the CAHPS survey and HEDIS are complementary quality monitoring strategies. Our results suggest that health plans that provide better access and customer service also provide better clinical care.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 046765293

Download citation: RISBibTeXText

PMID: 11717573

DOI: 10.2307/3768104


Related references

National Quality Monitoring of Medicare Health Plans. Medical Care 39(12): 1313-1325, 2001

Relationship between quality of care and racial disparities in Medicare health plans. JAMA 296(16): 1998-2004, 2006

Comparison of data quality for reports and ratings of ambulatory care by African American and White Medicare managed care enrollees. Journal of Aging and Health 18(5): 707-721, 2006

Supplement: Health Care Quality and Disparities: Lessons from the First National Reports || How the National Healthcare Quality and Disparities Reports Can Catalyze Quality Improvement. Medical Care 43(3): I82-I88, 2005

Health-related quality of life and quality of care in specialized medicare-managed care plans. Journal of Ambulatory Care Management 36(1): 72-84, 2013

Health plan performance measurement: does it affect quality of care for Medicare managed care enrollees?. Inquiry 45(2): 168-183, 2008

Quality of care, health care costs, and utilization among Medicare Part D enrollees with and without low-income subsidy. Population Health Management 15(2): 101-112, 2012

Satisfaction with access to and quality of health care among Medicare enrollees in a health maintenance organization. Western Journal of Medicine 166(4): 242-247, 1997

Monitoring quality of care under national health insurance Comparative consumer ratings of Israels four health plans. JGIM 13(SUPPL 1): 59, 1998

Supplement: Health Care Quality and Disparities: Lessons from the First National Reports || Variation in Quality of Men's Health Care by Race/Ethnicity and Social Class. Medical Care 43(3): I72-I81, 2005

Supplement: Health Care Quality and Disparities: Lessons from the First National Reports || Challenges in Measuring Nursing Home and Home Health Quality: Lessons from the First National Healthcare Quality Report. Medical Care 43(3): I24-I32, 2005

Supplement: Health Care Quality and Disparities: Lessons from the First National Reports || The National Healthcare Quality and Disparities Reports: An Overview. Medical Care 43(3): I3-I8, 2005

National and state trends in quality of care for acute myocardial infarction between 1994-1995 and 1998-1999: the medicare health care quality improvement program. Archives of Internal Medicine 163(12): 1430-1439, 2003

Encouraging Medicare Advantage Enrollees to Switch to Higher Quality Plans: Assessing the Effectiveness of a "Nudge" Letter. Mdm Policy and Practice 2(1): 2381468317707206, 2017

Quality and equity of care in the veterans affairs health-care system and in medicare advantage health plans. Medical Care 49(6): 560-568, 2011