Analysis Found Expensive Care Doesn't Mean Better Care
YONKERS, N.Y., Sept. 26, 2013 /PRNewswire-USNewswire/ -- For the fourth year in a row, Consumer Reports published rankings of hundreds of health insurance plans across the United States to help consumers determine which ones may be best for them. This marks the first time the organization took additional steps to identify plans that both provide high-quality care and avoid costly care.
The full report is available in the November issue of Consumer Reports. The latest health plan rankings are available for free online at www.ConsumerReports.org/healthinsurance.
The rankings data and the "Best Value" designation come from the National Committee for Quality Assurance (NCQA), a respected non-profit health care quality measurement group. Overall, Consumer Reports and NCQA have information on more than 1,000 private, Medicare Advantage, and Medicaid plans.
The new Best Value designation for plans is based on how well a plan helps people with diabetes manage their condition. Consumer Reports focused on diabetes for several reasons. The disease has reached epidemic proportions, affecting some 26 million Americans. In addition, managing diabetes requires good, basic care for things like high blood pressure, cholesterol, and blood glucose levels—as well as coordination among providers. Plans that get diabetes care right are likely to do a lot of things well. Finally, treating diabetes is expensive, especially if basic care is neglected, so plans that provide good diabetes care for less money should have more resources available to cover other conditions or to reduce premiums.
The analysis of 997 Medicare advantage and private plans identified 114 plans that got a Best Value designation, earning check marks for both providing high quality care and avoiding costly care. Many more—402 plans—got a check mark for one but not both of those measures. And, 481 plans didn't get a check mark for either. That could be because they had poor results for these measures or they did not report the data needed for this analysis.
"Consumer Reports' analysis found that expensive care doesn't mean better care. Many people incorrectly assume that the more money that's spent on health care, the better health care will be," said John Santa, M.D., medical director of Consumer Reports Health. "But as these ratings show, the data found no connection between cost and quality."
The rankings could be especially valuable to consumers this year because health insurance becomes a requirement for just about everyone in the U.S. on January 1, 2014 under the federal Affordable Care Act (ACA). Though much attention is now being focused on the ACA, at least 80 percent of Americans will notice almost no change because they already have insurance that meets the law's requirements. This includes the 49 percent of Americans who get health insurance through their or someone else's job, as well as people who get insurance through some type of government plan.
The centerpiece of the transformed health care system is an entirely new way of choosing and purchasing individual health insurance known generically as marketplaces. They open for business on October 1, 2013, in every state. In subsequent years, it will take place on the same schedule as Medicare open enrollment: Oct. 15 through Dec. 7.
Plans listed in these new marketplaces and in this Consumer Reports/NCQA insurance ranking aren't identical. That's because all the plans in the marketplace are new, so NCQA doesn't yet have data for them. Nonetheless, a plan's record in a specific state provides a good indication of how well a new and similar marketplace plan by the same provider may perform.
Consumer Reports' publication of NCQA ranking of more than 1,000 private, Medicare Advantage, and Medicaid health insurance plans nationwide can be viewed through the lens of coverage via an employer (or through a family member's), through Medicare or Medicaid, or insurance on-your-own through the new health exchange marketplaces.
The report provides overall scores from 1 to 100 reflecting plans' performance across many aspects of care. These include cancer screenings, immunizations and other preventative services, and treatments for chronic diseases such as heart disease, osteoporosis and mental illness. Customer satisfaction and results from NCQA accreditation surveys also contribute to the overall scores.
Consumer Reports has created a free online tool at www.HealthLawHelper.org to help consumers better understand how they may be affected by the Affordable Care Act. Based on responses to a few questions, the tool provides a customized, printable report that identifies what an individual consumer should look for in the insurance marketplace. The tool does not require users to provide their name or other personally identifying information. The tool is coming soon in Spanish at www.AseguraTuSalud.org.
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For non-media related questions about this report please send an email to: ExternalRelations@cr.consumer.org with the subject line: "Health Insurance Rankings Question."
SOURCE Consumer Reports