Comparing VA and Medicare Advantage quality
VA's quality performance was significantly better than that reported by Medicare Advantage plans for each of 12 nationally-recognized measures of quality, according to a study in the March 31, 2016, issue of Inquiry.
The study team, led by researchers with the Providence (Rhode Island) VA Medical Center, and including former VA Undersecretary for Health Kenneth W. Kizer, also looked at whether Medicare Advantage and VA assessments of quality agreed with each other. According to the team, little is known about the relative accuracy of these quality indicators for Veterans or others receiving care in more than one health care system, as many Veterans do.
The team used the Healthcare Effectiveness Data and Information Set (HEDIS) for their comparisons. HEDIS is a tool used by more than 90 percent of America's health care plans to measure performance on important dimensions of care and service.
Among the factors taken into account in HEDIS are asthma medication use; beta-blocker treatment after heart attacks; blood pressure control; diabetes care; breast cancer screening; antidepressant management; immunization status; and cessation advice for smokers.
VA and Medicare Advantage both use HEDIS. The researchers found that reported VA performance was significantly better than reported MA performance for all 12 HEDIS measures they looked at. VA's edge ranged from 9.8 percent in diabetes control, to 54.7 percent for blood pressure control in diabetes patients.
While neither Medicare Advantage plans nor VA fully captured quality of care information for dually enrolled patients, the team hypothesized that VA's system-wide electronic health record may allow for more complete capture of quality information from multiple providers and settings.