This National Committee for Quality Assurance (NCQA) report on the state of health care quality, released on October 22, found  that overall health care quality in America—including private and public coverage—has been virtually stagnant since 2008.  Previous NCQA reports have found health care quality had improved significantly every year for the past 12 years and NCQA attributes the reversal to the economy and the fee-for-service (FFS) payment model.  In addition to the overall trends, the NCQA report notes that the percentage of patients receiving quality care for many conditions, including for M/SU conditions, remained under 50 percent while some M/SU conditions displayed quality reductions.

From the executive summary:

There are probably multiple reasons for the flat results of 2009. First, and perhaps most important, is the lagging U.S. economy. The current downturn began in the fourth quarter of 2008, but employers and health plans had already begun to shift their focus almost entirely to the cost of coverage. When purchasers are buying on the basis of cost alone, plans naturally follow suit and pay more attention to negotiating discounts and less to improving performance. And the most effective tool — tying payments to performance — is not being utilized enough, especially by the giant Medicare program.

Millions of Americans lost their jobs and insurance; many shifted to Medicaid and the Children’s Health Insurance Program (CHIP); others became uninsured. Several states have made enormous strides in focusing their Medicare and CHIP programs on quality but they are not yet the majority. While more than half of Americans with private insurance are in a HEDIS-reporting plan, only 25 percent of Medicaid beneficiaries and 17 percent of Medicare beneficiaries are.

Full report: The State of Health Care Quality 2009 (PDF | 1.69 MB)

The National Committee for Quality Assurance. (2009). The state of health care quality 2009.