The trusted source for
healthcare information and
Data are from survey of beneficiaries, NCQA
Medicare beneficiaries now have an opportunity to check out quality and satisfaction information about managed care plans before they sign up by examining information posted on the Internet by the Health Care Financing Administration (HCFA).
The Medicare Web site, www.medicare.gov, contains the results of a survey of more than 100,000 Medicare beneficiaries enrolled in managed care plans that participate in Medicare as well as selected performance data from the health plans’ Health Plan Employer Data and Information Set (HEDIS) assessments. The Medicare Compare database contains information about Medicare managed care plans that serve about 6.5 million Medicare beneficiaries. The information will be updated on a quarterly basis.
The information is being provided to help Medicare beneficiaries make the best choices for themselves and their families, and is part of the Clinton administration’s plan to strengthen patients’ rights and emphasize quality of care, a HCFA spokesperson says.
In the spring of 1998, HCFA sent detailed surveys to about 136,000 Medicare beneficiaries asking them to assess the quality of their health plans. The survey was developed by HCFA and the Agency for Health Care Policy and Research.
In general, beneficiaries ranked their health plans highly. On a scale of 0 to10 with 10 being the best, almost half rated their plans a 10. Another 34% gave their plan an 8 or 9. About 70% of the respondents reported that their physicians always communicate well, and another 23% said their doctors usually communicate well.
The Web site also contains information from the first Medicare HEDIS assessment of health plan quality. HCFA required plans to report 30 HEDIS performance measures and then audited the seven measures deemed most important to Medicare beneficiaries. The National Committee for Quality Assurance developed HEDIS and collected the information from the health plans.
The data showed variability in the quality of care provided by Medicare managed plans:
• Approximately 75% of women between 52 and 69 who were enrolled in a managed care plan had at least one mammogram in 1996 and 1997.
• About 75% of heart attack survivors over the age of 35 received beta blocker prescriptions when they were discharged from the hospital.
• Half of the beneficiaries with diabetes received an eye exam in 1996.
The Web site includes telephone numbers and Web site addresses for health plans, benefit and service packages offered by each plan, and helpful hints for navigating within the database. The information can be broken down by state or by zip code.