STUDY finds HMOs making greater effort to control high blood pressure, cholesterol

Thursday, September 6th 2001, 12:00 am
By: News On 6

WASHINGTON (AP) _ HMOs have made record gains in treating high blood pressure and trying to lower cholesterol levels, two easily neglected conditions that could lead to heart disease and other deadly ailments, an annual study of health insurance plans says.

In 2000, health plans reported increases in the percentage of heart attack sufferers who were screened and treated for high cholesterol, hypertension patients who were steadily treated for high blood pressure, and diabetes victims who received eye exams and other screenings that kept their conditions from worsening, said the National Committee for Quality Assurance, a Washington-based HMO accrediting group.

``Health plans that work with their physicians, hospitals and members can raise the bar dramatically on quality,'' said Dr. Sam Nussbaum, the chief medical officer of Anthem Blue Cross Blue Shield.

The 372 health plans that voluntarily share patient data with the accrediting group cover 63 million Americans. While health plans are not performing the treatments, the group aims to rate the insurers on how well they offer, promote and pay for good health care. A dozen measures look at clinical progress such as the screenings, and 10 other measures cover patient satisfaction such as how soon a claim was paid or how quickly a treatment was provided.

Researchers caution that roughly 35 percent of HMOs do not participate in the program, but praised the progress of ones who do.

``For two years in a row, we've seen that participating health plans are getting better; the rest of health care is a real question mark,'' said Margaret E. O'Kane, president of the accrediting group.

This year, the study found:

_The average percentage of heart attack victims in a given plan who received cholesterol screenings rose to 74 percent in 2000, from 69 percent in 1999. Such screenings can reduce a second heart attack or stroke by as much as 40 percent.

_The average percentage of hypertension patients who were treated for high blood pressure jumped 13 percentage points in 2000, from 39 percent to 52 percent.

_The average percentage of diabetes sufferers getting eye exams rose to 48 percent in 2000, from 45 percent in 1999. These screenings help prevent blindness, a common complication of diabetes.

The NCQA said the reporting plans could do better on screening people for chlamydia, a common but highly treatable sexually transmitted disease, and following up on treatments for mental illnesses.

In the face of the ongoing debate in Congress on a patients' bill of rights, the health plans did see some increases in the satisfaction of their member patients, the study said.

In 2000, 66.6 percent of enrollees said customer service was ``not a problem,'' up from the 64.5 percent who said so in 1999, and the 53.9 percent who reported such feelings in 1998.

The report said there was a large degree of variation among the plans in many preventive measures, including diabetic eye exams, cervical cancer screenings and rates for controlling high blood pressure.

The report was based on data compiled by NCQA and provided by the health plans.