Over objections of the Illinois Association of HMOs and with the support of a local business coalition, the National Committee for Quality Assurance last week released a sample "report card" on HMOs serving the Chicago and Wisconsin markets.
The matter illustrates the divergent interests involved in releasing such performance data to the public: Employers want it; HMOs will supply it; and when the NCQA releases it, everyone qualifies the results.
The Midwest Business Group on Health, an employer coalition, requested the sample report card from the NCQA to encourage more Chicago-area employers to use the NCQA's data to evaluate health plans, said Larry Boress, MBGH vice president.
The NCQA uses a performance measure system called the Health Plan Employer Data and Information Set, or HEDIS, to collect data from managed-care plans. Managed-care companies supply HEDIS data to the NCQA on a voluntary basis.
The sample Illinois report card, which covered only five out of some 50 HEDIS measures for 10 plans, was not intended as "a definitive evaluation of any of the plans," Boress said.
For that reason, the Illinois Association of HMOs opposed the release of the report, calling it an incomplete version of the NCQA's Quality Compass.
The Quality Compass is the NCQA's database of comparative information on 329 managed-care plans that have submitted HEDIS data to the NCQA.
Only 10 Illinois plans provide data for Quality Compass, said Bob Burger, executive director of the state HMO association. The group has 24 members.
Cigna HealthCare of Illinois had the worst scores on the prototype Illinois report card. That's because it chose not to put time and resources into gathering data both from charts in doctor's offices and claims reports, said Wendell Potter, a Cigna spokesman in Philadelphia.
Although Cigna supports the HEDIS effort, the company objects that "some publications are portraying it as the measure of the health plans' quality, which we never intended it to be," Potter said.
Aetna U.S. Healthcare had an average showing on the report card. Alan Rosenberg, M.D., regional quality management medical director for Aetna in Chicago, said that although he wished the state report card covered all the HEDIS measures, "to begin to put out quality measures and to begin to have purchasers seriously consider them is useful in the long term."