Government Agency Navigation

Quality of Women's Health Care

Narrative

Health care quality indicators can provide important information about the effectiveness, safety, timeliness, patient-centeredness, and efficiency of health services.1 Some common indicators used to monitor women's health care in managed care plans include screening for chlamydia and cervical cancer, and the receipt of timely prenatal and postpartum care.2

Often referred to as a "silent" disease because most infected individuals do not experience symptoms, chlamydia is the most commonly reported bacterial STD in the United States.3 In 2010, women aged 21–24 years enrolled in Medicaid were more likely than those enrolled in commercial plans to have been screened for chlamydia (62.3 versus 45.7 percent, respectively).

In comparison, cervical cancer screenings appear to be more accessible to women with commercial coverage than to those covered by Medicaid. Among women aged 21–64 years, cervical cancer screenings were received at least once during the previous 3 years by 77.0 percent of commercially-insured women and 67.2 percent of those covered by Medicaid. Cervical cancer is almost entirely preventable with appropriate screening, evaluation, and treatment.4 (More information on Cancer and Preventive Care.)

In 2010, women with commercial insurance coverage were also more likely than those with Medicaid to have received timely prenatal and postpartum care. More than 90 percent of commercially-insured women received prenatal care in either their first trimester or within 42 days of enrollment, compared to 83.7 percent of those covered by Medicaid. Similarly, 80.7 percent of women with commercial coverage had a postpartum visit between 21 and 56 days after delivery, compared to 64.4 percent of women participating in Medicaid. Although Medicaid-insured women are less likely to have received timely prenatal and postpartum care than commercially- insured women, they have made greater improvements since 2001. For example, the proportion of women receiving timely postpartum care increased 21.5 percent among Medicaid participants compared to 4.8 percent among commercially-insured postpartum women.

1 Agency for Healthcare Research and Quality. 2010 National Healthcare Disparities and Quality Reports. Accessed 10/12/12.

2 National Committee for Quality Assurance. The State of Health Care Quality 2011. Washington, DC: NCQA, 2011. Accessed 10/12/12.

3 Centers for Disease Control and Prevention. Chlamydia Fact Sheet. Accessed 10/12/12.

4 American Cancer Society. Cancer Prevention & Early Detection Facts & Figures. Accessed 10/12/12.

Graphs

Data

HEDIS®*Screening for Chlamydia** and Cervical Cancer,†by Payer, 2010
Payer Percent of Women
Chlamydia Screening Cervical Cancer Screening
*Health Plan Employer Data and Information Set is a registered trademark of NCQA.
**The percentage of sexually active women aged 21-24 years who had at least one test for Chlamydia in the past year.
†The percentage of women aged 21-64 years who had at least one Pap test in the past 3 years. Source: National Committee for Quality Assurance. The State of Health Care Quality 2011. Washington, DC: NCQA, 2011. Accessed on 10/12/12.
Commercial 45.7 77.0
Medicaid 62.3 67.2
HEDIS®* Timeliness of Prenatal** and Postpartum Care,† by Payer, 2001-2010
Year Percent of Women
Prenatal, Commercial Insurance Prenatal, Medicaid Postpartum, Commercial Insurance Postpartum, Medicaid
*Health Plan Employer Data and Information Set is a registered trademark of NCQA.
**The percentage of pregnant women who received a prenatal care visit in either the first trimester or within 42 days of enrollment.
†The percentage of women who had a postpartum visit on or between 21 and 56 days after delivery. Source:
2001 85.1 72.9 77.0 53.0
2002 86.7 70.4 77.0 52.1
2003 89.4 76.5 80.3 55.3
2004 90.8 78.2 80.6 56.5
2005 91.8 79.6 81.5 57.2
2006 90.6 81.2 79.9 59.1
2007 91.9 81.5 82.0 58.6
2008 92.4 81.9 82.8 62.6
2009 93.1 83.4 83.6 64.1
2010 91.0 83.7 80.7 64.4