Health plans in the New England region (CT, ME, MA, NH, RI, VT) continued to outpace all others and the quality of care in the South Central region (AL, KY, MS, TN, AR, LA, OK, TX) tended to lag the most. Among the findings:

-- Health plans in New England were 16.3 percent more likely to treat diabetic patients according to accepted guidelines compared with health plans in South Central states; -- Health plans in Mid-Atlantic states were 14.1 percent more likely to adhere to guidelines for treating patients with cardiovascular disease compared with plans in South Central states; -- New England health plans were 19.2 percent more likely to ensure that all patients received all appropriate cancer screenings compared with health plans in South Central states; and -- Health plans in Pacific states (AK, CA, HI, OR, WA) were 20.8 percent more likely to appropriately treat and follow up with patients with mental health and substance abuse issues compared with health plans in West North Central states (IA, NE, KS, ND, MN, SD, MO).

"The quality of your care should not depend on geography," said Cristie Upshaw Travis, Chief Executive Officer of the Memphis Business Group on Health. "These quality gaps translate into preventable heart attacks, strokes and other serious medical events, not to mention billions of dollars in avoidable medical costs."

Value: Cost, Quality and a Bothersome Scattergraph

For the third year, NCQA measured the value of health plans by combining quality measures with an assessment of how many resources were used to achieve those results. Data were collected in four key chronic disease areas: diabetes, cardiovascular disease, asthma and chronic obstructive pulmonary disease. There were wide variations in both spending and quality and NCQA found essentially no relationship between cost and quality, a disturbing and counterintuitive finding in an economy where price is often used as a proxy for quality.

"Health care doesn't follow the pay more get more rule," said NCQA Executive Vice President Greg Pawlson, M.D., "Areas of the country with higher costs are more likely to have lower rather than higher quality. You can't simply spend your way to better health or to a health care system that delivers high value for the costs."

The Rest of the System

Finally, little is known about the quality of care for the roughly 190 million Americans who are not in a health plan that measures and reports on quality. More than half (56%) of commercially insured people are in plans that report HEDIS to NCQA but only 25% of Medicaid beneficiaries and 16% of Medicare beneficiaries are in such plans. Many of the rest are in fee for service care systems where quality measurement is not measured in a comprehensive manner. Congress has been working in recent years to expand the use of quality reporting in both these programs.

NCQA's full State of Health Care Quality 2009 report is available on the Web at ncqa/sohc. Much of the data from the report is used in NCQA's online Health Plan Report Card, which allows consumers to compare health plans based on NCQA Accreditation results and HEDIS quality scores. To see the Health Plan Report Card, visit reportcard.ncqa.

SOURCE: NCQA