After learning more about the process and criteria with which employers select a health plan, we decided to go on the road (or Zoom in today’s world) to share with employers how they can assess whether their health plans are managing employee health effectively.
NCQA provided employers with performance data for the health plans they use and shared how their plans’ performance compared with state and national benchmarks on measures such as obesity management, diabetes, low back pain and avoidance of antibiotics for adults with acute bronchitis.
Across all conversations, three themes emerged:
- Employers were surprised to see the variation in health plan performance for measures of interest to them, such as HbA1c, blood pressure and low-value care. For example, in the top 10% of commercial plans 66% of individuals with diabetes HbA1c under control. In the lowest performing plans, that number drops to 37%. Showing this variation helped them see that plans can influence quality.
- Employers will learn a great deal about the health of their populations by asking how their plan compares to state and national benchmarks. This information will likely reveal an entirely new story. In one presentation, employers were surprised to see that their health plan performed below the 25th percentile of all plans across the country.
- There is a great opportunity for employers to leverage plan and population data to drive quality improvement at the plan level. A few innovative employers are putting performance guarantees around care quality and holding health plans accountable, but most are not.
Are you assessing health plan quality? If so, we want to hear about it. Do you need help assessing your plan or understanding how it compares with others? Email us at email@example.com.
We’re happy to help.