And it should be noted that NCQA's study only covers about the two out of five -- or 116 million -- Americans whose health plans report measures of improvement in NCQA's Health Care Effectiveness Data and Information Set (HEDIS). The most likely to report are large, commercial health plans from big companies, such as Fortune 400 firms that have performance targets to meet, according to Danzig.

"Plans that don't report tend to be either smaller plans that don't see this as a priority or large state-based plans (i.e., Blues plans) that are immune to market pressures to report (i.e. they have a large share of the market and purchasers have little sway with them)," Danzig explains.


Government-run plans are also often report shy: only about 16 percent of all Medicare plans, mostly Medicare Advantage plans, that are partly privately managed, pass on their HEDIS stats to NCQA.

In the NCQA report, Medicare and Medicaid plans lag behind fully commercial ones in quality improvement, and NCQA says the public plan quality measures have been stagnating for the last three years.

So what should be done? Among other recommendations, NCQA suggests that politicians include in the reform bills now passing through Congress some mechanism to force insurance plans to report health care measures or lose accreditation. And for Medicare and Medicaid, they would like to see some sort of pay-for-performance strategy, along with better data reporting.

To download the free report, visit: http://www.ncqa.org/tabid/836/Default.aspx

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