In an ongoing effort to increase health care transparency and give Utahns valuable information to make health care decisions, the Utah Department of Health’s (UDOH) Health Data Committee and the Division of Health Care Financing have published the 2010 Health Plan Quality of Care Report. The report evaluates the quality of performance for selected Utah health plans covering more than 900,000 members across the state—roughly 40.0% of the insured.

Performance measures come from data collected by Utah health plans. Participating commercial HMOs were Altius Health Plans, Regence HealthWise, SelectHealth, and United Healthcare of Utah. Participating Medicaid HMOs included Healthy U and Molina Healthcare of Utah. Two Children’s Health Insurance Program (CHIP) plans are also included: Public Employees Health Program and Molina Healthcare of Utah.

“Health care transparency is important,” said Dr. David Sundwall, UDOH Executive Director “The information in the report highlights not only the areas where health plans are doing well, but also those in need of improvement,” he added. “It will help individuals choose the plan that best fits their needs and those of their family.”

While Utah’s commercial HMOs were above national averages for several measures, they also had the most room for improvement, scoring higher than national counterparts for only 30% of the reported measures. Results show commercial HMOs either met or exceeded national averages in providing adult’s access to preventive services and the use of appropriate medications for people with asthma. Commercial HMOs scored lower than their national counterparts in children’s access to primary care providers and childhood immunizations.

Medicaid HMOs did well when compared to their national counterparts, scoring above the national averages on more than 60% of the measures. They scored higher than the national average on comprehensive diabetes care, adults’ access to preventive services, and childhood immunizations, but could improve in providing chlamydia screenings for women ages 16 to 25, as well as breast and cervical cancer screenings.

Utah’s CHIP HMOs were on par with or above national averages on 50% of the reported measures, including child immunizations and appropriate treatment for children with upper respiratory infections and pharyngitis, but could do better in adolescent well-care visits.

Since 1996, the Office of Health Care Statistics has been collecting HMO quality of care data. During this time, HMOs have made considerable progress in delivering health care to their members. HMOs have increased their scores in a number of different areas, including adults’ access to preventive services, cervical cancer screenings, well-child visits, and adolescent well-care visits. Collecting the data not only allows consumers to make informed decisions regarding their health care, it also allows health plans to allocate resources toward areas that need improvement. These actions should improve the delivery of health care and allow more individuals access to preventive care.

For a copy of the report, which includes graphics that depict the performance measures, please visit www.health.utah.gov/myhealthcare/reports/hedis

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