The continuing transformation of the health care system into one characterized by competing managed care health plans has raised concerns regarding the quality of care that results in this new environment. It is for this reason that policy makers, purchasers, the media, and private organizations have devoted significant resources to measuring health plan quality. The goal of this project is to examine the level of, and changes in, health plan quality in this new environment. We will analyze the relationship between quality (and changes in quality) and a variety of market and plan factors. Our measures of quality are based on the Health Plan Employer Data and Information Set (HEDIS) and the Consumer Assessment of Health Plans Survey (CAHPS), which, though imperfect, are the most widely used indicators of non-financial aspects of health plan performance. The project will make use of a comprehensive panel data set capturing plan quality, including data not publicly reported. The project will also incorporate unique data on the overlap in plans' provider networks because such overlap could affect health plan performance. Identification of factors that promote quality will help policy makers identify where competitive strategies may fail to improve quality and where other policy actions may be needed. The nature of the data surrounding managed care and the consumers' health care bill of rights could be affected by evidence regarding HMO quality and changes in that quality over time.
| Maeng, Daniel D; Scanlon, Dennis P; Chernew, Michael E et al. (2010) The relationship between health plan performance measures and physician network overlap: implications for measuring plan quality. Health Serv Res 45:1005-23 |
| Scanlon, Dennis P; Swaminathan, Shailender; Lee, Woolton et al. (2008) Does competition improve health care quality? Health Serv Res 43:1931-51 |
| Swaminathan, Shailender; Chernew, Michael; Scanlon, Dennis P (2008) Persistence of HMO performance measures. Health Serv Res 43:2033-49 |
| Chernew, Michael; Gibson, Teresa B (2008) Cost sharing and HEDIS performance. Med Care Res Rev 65:713-28 |
| Haas, Jennifer S; Fitzmaurice, Garrett; Brawarsky, Phyllis et al. (2007) Association of regional variation in primary care physicians'colorectal cancer screening recommendations with individual use of colorectal cancer screening. Prev Chronic Dis 4:A90 |
| Phillips, Kathryn A; Liang, Su-Ying; Ladabaum, Uri et al. (2007) Trends in colonoscopy for colorectal cancer screening. Med Care 45:160-7 |
| Liang, Su-Ying; Phillips, Kathryn A; Nagamine, Mika et al. (2006) Rates and predictors of colorectal cancer screening. Prev Chronic Dis 3:A117 |
| Gellad, Walid F; Huskamp, Haiden A; Phillips, Kathryn A et al. (2006) How the new medicare drug benefit could affect vulnerable populations. Health Aff (Millwood) 25:248-55 |
| Liang, Su-Ying; Phillips, Kathryn A; Haas, Jennifer S (2006) Measuring managed care and its environment using national surveys: a review and assessment. Med Care Res Rev 63:9S-36S |
| Phillips, Kathryn A; Van Bebber, Stephanie; Marshall, Deborah et al. (2006) A review of studies examining stated preferences for cancer screening. Prev Chronic Dis 3:A75 |
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