MCPR 2004 - Measuring the Quality of Pennsylvania's Commercial HMOs - Key Findings
Every Pennsylvania HMO performed better than the National HMO Average in the following categories:
Cholesterol screening after acute cardiovascular events
Beta blockers after a heart attack
Providing the recommended childhood immunizations
On average, Pennsylvania HMOs improved from the prior year in 11 of the 17 "Staying Healthy" measures.
On average, the majority of diabetes "Staying Healthy" measures, as well hospitalization rates, improved at the statewide level; however, some plans did not show consistent progress on each measure from the previous year.
Over half of the plans reported an increase from the prior year in the percent of plan members who gave their HMO the highest satisfaction rating.
On average, Pennsylvania HMOs outperformed their national counterparts in all the "Member Satisfaction" measures for which there was a national average available.
Since last year, there were significant decreases in HMO hospitalization rates for: adult asthma (-19.1%); pediatric asthma (-14.3%); pediatric ear, nose, and throat infections (-32.0%); chronic obstructive pulmonary disorder (-15.9%); and diabetes (-9.6%). There also was a significant increase in the HMO hospitalization rate for high blood pressure (+7.4%).
The in-hospital complication rate after prostatectomy decreased 28.3%, from 8.4% in 2003 to 6.0% in 2004 for HMO members. During that same time, the rate for the indemnity sample increased 7.4%, from 8.8% in 2003 to 9.5 in 2004.
The in-hospital complication rate after abdominal hysterectomy decreased 13.1% from 9.8% in 2003 to 8.5% in 2004 for HMO members. The in-hospital complication rate after vaginal hysterectomy decreased 21.2% from 7.3% in 2003 to 5.7% in 2004 for HMO members. Despite these improvements, both rates were still higher than the same rates for the indemnity sample.
Neck and back surgeries are 9.6% more likely to be performed in the inpatient setting for HMO members than for indemnity members. Similarly, breast cancer procedures were 9.9% more likely to be performed in the inpatient setting for HMO members than for indemnity members.
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