WASHINGTON, D.C. – Highlighting a number of recent studies that uncover substantial variations in the quality of medical care that patients receive, the Alliance of Community Health Plans (ACHP) today issued a new report that urges federal policymakers to hold health plans accountable by publicly reporting their performance, increasing patient participation in health care decision-making and establishing payment systems that reward efficiency, quality and value.
“When it comes to health care quality, all providers and health plans are not created equal,” said Jack Ebeler, president and CEO of ACHP. “Patient care also varies by medical condition and geography. Closing the quality gap will require a firm commitment to putting patients in the driver’s seat. Patients need tools to make informed health care choices, and providers who commit to their patients and better care should be rewarded when their efforts produce greater efficiency, quality and value.”
The report, Variations in Health Care: Implications for Quality Improvement, makes recommendations to policymakers that address variations in care and improve overall health care quality. Key recommendations include:
- Enhance the public reporting of standardized performance measures by health plans and providers to increase information available to consumers and providers.
- Disseminate information about quality and care to patients and consumers; promote web-based medical technologies and expand self-management tools to increase patient engagement.
- Promote provider payment systems, such as pay-for-performance initiatives, that reward efficiency, quality and value.
A powerful human and economic argument can be made in support of improving the quality of medical care in the United States. Fifty-seven thousand patient lives, $1.6 billion and nearly 41 million sick days would be saved if all Americans received the level of care provided to enrollees in the top ten percent of health plans, according to National Committee for Quality Assurance data referenced in the ACHP report.
The ACHP report also reviews recent studies on variations in health care quality. One report indicates that Americans receive recommended medical care about 50 percent of the time.
The cost of health care does not necessarily determine quality. According to the ACHP report, Medicare spending is twice as high in some areas than others, and additional spending in those areas did not lead to lower mortality rates, better functional status or higher patient satisfaction.
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The Alliance of Community Health Plans (ACHP) brings together a select group of innovative, not-for-profit or provider-sponsored health plans and provider organizations focused on improving health care quality in the United States. ACHP offers member plans a forum for learning, innovation and advocacy that allows them to promote the highest standards of health care quality and health improvement in their communities and nationally. ACHP member plans serve more than 12 million people across the United States. Additional information about ACHP is available at www.achp.org.
Capital Health Plan (Tallahassee, Florida); Fallon Community Health Plan (Worcester, Massachusetts); Group Health Cooperative of South Central Wisconsin (Madison, Wisconsin); Group Health Cooperative (Seattle, Washington); Health Alliance Plan (Detroit, Michigan); HIP Health Plan of New York (New York, New York); HealthPartners (Minneapolis, Minnesota); Kaiser Foundation Health Plans and The Permanente Federation (Oakland, California and multi-state); M·Plan (Indianapolis, Indiana); UCare Minnesota (Minneapolis, Minnesota); Excellus-Univera Healthcare (Buffalo, New York).