Mandatory public reporting of care performance did not affect quality of care for Medicare managed care patients
Research Activities, March 2009, No. 343
Medicare managed care (MMC) plans were required to begin publicly reporting their performance on certain care measures in 1997. It was assumed that plans that had to report success in various areas, such as mammogram rates for elderly women, would improve care in that area, so that individuals would want to enroll or continue enrollment in the plans. However, this mandatory reporting requirement did not seem to affect quality of care on four measures for MMC plans, found a new study.
M. Kate Bundorf, Ph.D., of Stanford University, and colleagues examined performance of mammogram rates for women aged 65 to 69 years, use of beta blockers for heart attack patients, rates of flu shots, and annual eye exams for people with diabetes for MMC plans. They studied plan performance from 1993 to 1995 (prior to mandatory reporting) and from 1997 to 1999 (following mandatory reporting). Although performance of these measures improved for MMC enrollees following the mandatory reporting, they also improved for Medicare beneficiaries not enrolled in these plans. For example, rates of increase between 1995 and 1999 among MMC versus non-MMC enrollees were 3 versus 12 percent for mammograms, 14 versus 15 percent for use of beta blockers, and 9 versus 8 percent for flu shots between 1995 and 1999. Rates of eye exams for people with diabetes rose 5 percent from 1997 to 1999 for MMC enrollees and 8 percent for non-MMC enrollees.
These findings suggest that the boost in care performance after mandatory public reporting may have been due to factors that affected all Medicare beneficiaries. This should be explored in further studies, suggest the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS11668).
See "Health plan performance measurement: Does it affect quality of care for Medicare managed care enrollees?" by Dr. Bundorf, Kavita Choudhry, B.A., and Laurence Baker, Ph.D., in the Summer 2008 Inquiry 45, pp. 168-183.