Trends in Quality Measure Performance Across Insurance Types

This white paper evaluates trends in quality measure performance across public and private insurance types from 2017 to 2022. It analyzes five widely used quality measures that assess access to care, preventive screenings, evidence-based treatments, and hospital readmissions. The measures, derived from the Healthcare Effectiveness Data and Information Set (HEDIS®), are used to compare health plan performance against national benchmarks. The analysis utilizes data from Inovalon’s Medical Outcomes for Research Effectiveness and Economics Registry (MORE² Registry®) and Medicare Fee-For-Service claims. The report highlights disparities in access to care, particularly among Medicaid enrollees, and examines the impact of the COVID-19 pandemic on healthcare access. It also discusses the importance of preventive screenings, such as breast cancer screening, and the implications of hospital readmissions on healthcare costs. The findings aim to inform quality improvement initiatives and public reporting efforts in the healthcare sector.