The information in this report enables Marylanders to compare health benefit plans on key quality measures regarding clinical processes and outcomes, as well as member satisfaction. The 2013 report contains information on 87 quality measures grouped into six categories: Primary Care and Wellness for Children and Adolescents (21 measures), Child Respiratory Conditions (8 measures), Women’s Health (5 measures), Primary Care for Adults (35 measures), Behavioral Health (8 measures), and Member Experience and Satisfaction (10 measures).
This year, 36% of the measures for HMO plans and 67% of the measures for PPO plans were better than the National Average. Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. scored highest among the HMO plans demonstrating performance better than the national average on 50 of the 75 quality measures with a national average benchmark to be compared against. Cigna Health and Life Insurance Company/Connecticut General Life Insurance Company scored highest among the PPO plans demonstrating performance better than the national average on 55 of the 75 quality measures with a national average benchmark to be compared against.
Overall, Maryland plans had strong performance in the categories of Primary Care and Wellness for Children and Adolescents, Child Respiratory Conditions, and Behavioral Health. Strong performance in these categories means that Maryland’s health benefit plans continue to work effectively in not only promoting prevention and wellness initiatives for their youngest members, but also in providing holistic care for members of all ages.
Consumers shopping for qualified health plans on Maryland Health Connection can find summary information on the Maryland Health Connection Quality Report 2013, and more detailed information using the 2013 Health Benefit Plan Quality and Performance Report.
“These quality data will help Marylanders choose between health benefit plans,” said Dr. Joshua M. Sharfstein, Secretary for the MD Department of Health and Mental Hygiene. “The direct comparisons made possible through Maryland Health Connection should accelerate important efforts for improvement.”
Ben Steffen, Executive Director of the Maryland Health Care Commission stated, “Expanding quality and performance measurement is a continuing State priority, these efforts would not be possible without the active participation of health plans that operate in the State. We look forward to their continued support as we publicly report on the Maryland RELICC (race/ethnicity, language, interpreter need, and cultural competency) Assessment quality measurement tool in 2014.”
The report will be posted on the Maryland Health Care Commission’s website at: http://mhcc.dhmh.maryland.gov/healthplan/Pages/default.aspx
Scharmaine Robinson, Chief
Health Benefit Plan Quality & Performance