If you are a Medicare beneficiary, should it matter whether your health care plan is for-profit or not-for-profit? According to a study published in the December issue of The American Journal of Medicine, it may.
By analyzing the first mandatory reporting of Quality-of-Care (QOC) data for Medicare patients, researchers from the Department of Health Policy and Management, Harvard School of Public Health; and the Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, found that for-profit plans provided significantly lower quality of care than not-for-profit plans.
Until 1997, QOC data came from surveys, was voluntarily provided by health plans, or came from regional plans. As such, some of these data may have been affected by biased selection and none of the data accounted for known geographic variation in the delivery of care. After 1997, reporting QOC data became mandatory in the Medicare program, thus providing nationwide data in the form of the Health Plan Employer Data and Information Set (HEDISTM). Using four measures of care, breast cancer screening, diabetic eye examination, beta-blocker medication after myocardial infarction, and follow-up after hospitalization for mental illness, the authors report that for-profit plans had lower ratings in all four measures than not-for-profit plans. Even after correcting for sociodemographic factors and health plan differences, for-profit plans still trailed not-for-profits in 3 of the 4 measures.
Pamela Poppalardo | EurekAlert!
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