Private fee-for-service Medicare Advantage plans tend to score lower on quality measures than other types of Advantage plans, according to a report presented at the Medicare Payment Advisory Commission’s November meeting.
Data from the Healthcare Effectiveness Data and Information Set, or HEDIS—a performance-measurement system developed by the National Committee for Quality Assurance, and Medicare’s Health Outcomes Survey—the first patient-reported outcomes measure used in Medicare managed care, were used to conduct the research. MedPAC researchers found that the private plans on average scored lower than PPOs or HMOs on selected HEDIS performance measures for breast-cancer screening and glaucoma screening in older adults.
Researchers also concluded that older plans—those who entered Medicare before 2004—had better average scores on most measures than newer plans. In general, the older plans were better at screening and outcome measures, although the newer plans were more efficient in monitoring persistent use of certain medications.
In other business, MedPAC voted on a series of recommendations that would place new requirements on the disclosure of financial relationships between drug manufacturers, devicemakers, physicians and other providers. One recommendation would establish a new federal reporting law where all manufacturers of drugs, biologicals and medical devices would submit to HHS their financial relationships with various providers.
Manufacturers would also have to report their relationships with pharmacists, pharmacy benefit managers and health plans, in addition to information on drug samples. Such information would be posted on a public Web site.