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NCQA: Health Plan Quality of Care is Improving

Cheryl Clark, for HealthLeaders Media, October 31, 2012

The NCQA measures found flat and slight downward changes in the percent of women 40-69 with at least one breast cancer screening within the last two years and flat or slight downward changes in Pap test cervical cancer screening in the last three years for women 21-64.

O'Kane highlighted a particularly "worrisome issue" in immunizations against measles, mumps and rubella, influenza, tetanus, polio and other recommended shots for children, which have been declining since 2009 "because of the urban legend that's out there about autism and immunizations."

"What we had hoped to see was a rebound, but that's not what we're seeing," she said. "Immunization rates have really flattened out."

The NCQA's chart showing all childhood immunizations for HMO commercial plans and Medicaid plans shows a rapid increase from about 50% between 1999 and 2001 to between 75% and 81% in 2008. But in 2009, those rates began to dip back several points, and didn't recover through 2011.

"Now, you're starting to have outbreaks of preventable childhood diseases..." O'Kane says. "It's very distressing. We just hope there can be more effective interventions."

O'Kane emphasized that the 2012 report reflects quality-of-care experiences for enrollees of 728 HMO and POS plans and 329 PPO plans, or 125 million people, 7 million more than in 2011.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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