Survey: 3 of Top 4 Health Plans In Nation Are In Mass.
10/27/2006
By Jeffrey Krasner, The Boston Globe Staff If you're going to get sick, do it in Massachusetts. The state boasts three of the country's top four health plans, according to rankings being released today by the National Committee for Quality Assurance, a respected Washington nonprofit. Harvard Pilgrim Health Care, the state's second-largest health plan, with about 1 million members, is ranked number one for the second consecutive year. Tufts Health Plan, the third-largest in Massachusetts, improved its ranking from third to second place. And Blue Cross and Blue Shield of Massachusetts, the largest plan, with about 3 million members, went from fifth place to fourth. A Harvard Pilgrim affiliate that does business in New Hampshire is ranked third. "It's like that Lake Wobegon thing, where all the children are above average," said John Friedman, a spokesman for the committee. "In Massachusetts, you're all excellent. If all health plans performed at these levels, we'd save thousands of lives a year." The committee surveys all health plans that voluntarily report clinical performance data, or about one-quarter of all US plans. It rates them on how well they do in treating and managing common illnesses, including asthma, cancer, heart disease, and depression, along with other healthcare measures like immunization and management of cholesterol levels after a heart attack. The group also surveys plan members to rate customer service, and how the insurers manage claims and resolve disputes. The annual survey is being published in this week's US News and World Report. Massachusetts has long been a leader in healthcare, in part because of the concentration of research and teaching hospitals. The state has also been a leader in creating new ways of paying for healthcare. But it is also plagued by some of the country's highest healthcare costs, which continue to rise by over 10 percent a year. Having plans that score highly in clinical measures ultimately leads to a healthier population, said Barbra G. Rabson, executive director of Massachusetts Health Quality Partners, whose goal is to help doctors and consumers improve care and to increase public access to ranking information. Many of the National Committee for Quality Assurance's measures are aimed at preventive care, said Rabson. "If you catch these diseases early it will have a positive impact on the health of the population," she said. Charles Baker, chief executive of Harvard Pilgrim, said his plan's continued outstanding performance is the combination of basics and innovative measures. "We take this stuff seriously," he said. "The member experience is not just a function of the members' interaction with us; it's also how we relate to employers and doctors. We have a holistic approach to those relationships." Dr. Allen J. Hinkle, Tufts' chief medical officer, said his plan's improved ranking means efforts to aggressively control rising medical expenses haven't come at the expense of quality. "It's a great endorsement for our approach," he said . "We haven't taken our eyes off quality." Fallon Community Health Plan, which is strongest in Central Massachusetts but is expanding into Eastern Massachusetts, also performed well. It is ranked 11th, down from ninth last year. Jeffrey Krasner can be reached at krasner@globe.com.
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