The June 2011 Commonwealth Fund Issue Brief, 'Assessing the Financial Health of Medicaid Managed Care Plans and the Quality of Patient Care They Provide,' used limited data to draw inappropriate conclusions regarding the Medicaid health plan industry asserts Medicaid Health Plans of America (MHPA), the trade group representing the industry (see also Medicare and Medicaid).
The results of authors Michael McCue and Michael Bailit suggest that a relationship exists between ownership status and quality of care and costs, when it is, in fact, impossible to accurately draw such conclusions given the large amount of missing and incomplete data in the study. Aside from the inadequate sample size that severely under-represented certain types of companies, the authors only had access to financial data from three-quarters of the plans identified as meeting the criteria for the study. Moreover, these data were obtained from different and inconsistent sources. Far worse is that the authors had preventive and chronic condition data from only one-third of the plans (with certain types of plans over- and under-represented), yet still opted to draw universal conclusions about ownership status and quality of care. Furthermore, the authors failed to analyze or account for other significant factors that could contribute to outcome differences among plans, including variations in market factors, geography, the acuity level of the populations being served and state Medicaid policies.
'MHPA represents both non-profit and for-profit health plans, all of whom share a common goal of improving the quality of care for Medicaid enrollees while collaborating with state partners to deliver that care in a cost-effective manner,' said Thomas L. Johnson, MHPA's President and CEO. 'It is irresponsible of the Commonwealth Fund to attempt to divide the Medicaid health plan industry on the artificial premise and conclusions of this faulty study.' Medicaid Health Plans of America supports the use of quality research to improve the delivery and quality of care to Medicaid enrollees, as long as it is based on sound methodology. Johnson continued, 'We encourage states to examine each potential Medicaid health plan that it partners with on its own merits, and not through the lens of such flawed and biased research.'
Keywords: Investing, Investment, Health Policy, Medicare and Medicaid.
This article was prepared by Managed Care Weekly Digest editors from staff and other reports. Copyright 2011, Managed Care Weekly Digest via NewsRx.com.
