Table 5.
Plan Fixed Effects Estimates (Constant Weight)—HEDIS Measures (Bootstrapped Standard Errors
| Covariate | Hemoglobin A1c Screening† | Diabetes Eye Exam Process Measure† | Lipid Screening Process Measure† | Nephropathy Monitoring Process Measure† | LDL Cholesterol Screening Process Measure | β-Blocker Medication Rate | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HHI | #HMOs | HHI | #HMOs | HHI | #HMOs | HHI | #HMOs | HHI | #HMOs | HHI | #HMOs | |
| HMO HHI‡ | 2.148 | NA | −1.636 | NA | −3.629 | NA | −5.543 | NA | −2.406 | NA | 13.267* | NA |
| (5.256) | NA | (5.795) | NA | (4.603) | NA | (6.027) | NA | (6.364) | NA | (7.670) | NA | |
| Number of HMOs‡ | NA | −0.235 | NA | 0.063 | NA | −0.146 | NA | 0.235 | NA | 0.063 | NA | −0.828*** |
| NA | (0.254) | NA | (0.211) | NA | (0.199) | NA | (0.287) | NA | (0.236) | NA | (0.244) | |
| HMO penetration‡ | 1.722 | 3.521 | 2.870 | 1.819 | 5.910 | 6.461 | 8.111 | 6.317 | 8.251 | 7.506 | −6.882 | −1.786 |
| (6.998) | (6.893) | (7.352) | (7.729) | (7.070) | (6.959) | (9.911) | (10.546) | (12.097) | (9.799) | (7.251) | (7.540) | |
| Hospital bed HHI‡ | 4.340 | 5.111 | −5.817 | −5.756 | 2.767 | 1.895 | 7.778 | 5.588 | −25.433** | −25.798*** | −13.723* | −8.301 |
| (11.119) | (11.346) | (9.418) | (9.906) | (11.028) | (10.360) | (14.309) | (15.720) | (11.671) | (9.245) | (7.387) | (7.184) | |
| Allows NCQA to report publicly | 3.684** | 3.536** | 4.371*** | 4.523*** | 1.439 | 1.452 | −0.289 | −0.161 | −0.743 | −0.696 | 4.333*** | 4.095*** |
| (1.692) | (1.740) | (1.526) | (1.490) | (1.121) | (1.049) | (1.754) | (1.650) | (1.522) | (1.150) | (1.357) | (1.307) | |
| Hybrid data collection | 3.718* | 3.826* | 2.872 | 2.810 | 5.392** | 5.484** | 5.199** | 5.219** | 8.511*** | 8.546*** | 13.667*** | 13.910*** |
| (2.072) | (1.960) | (3.204) | (3.277) | (2.431) | (2.590) | (2.461) | (2.581) | (2.077) | (1.660) | (2.060) | (1.900) | |
| 1998§ | −3.604*** | −3.740*** | −4.084** | −4.028** | −9.690*** | −9.676*** | −6.810*** | −6.572** | −5.552*** | −5.512*** | −1.904** | −2.382** |
| (1.153) | (1.239) | (1.636) | (1.591) | (1.554) | (1.726) | (2.492) | (2.592) | (1.226) | (1.057) | (0.925) | (0.936) | |
| 2000§ | 3.148*** | 3.126*** | 2.202*** | 2.180*** | 7.806*** | 7.697*** | 6.124*** | 6.096*** | 5.464*** | 5.438*** | NA | NA |
| (0.588) | (0.582) | (0.619) | (0.597) | (0.561) | (0.548) | (0.762) | (0.778) | (0.852) | (0.674) | NA | NA | |
| 2001§ | NA | NA | NA | NA | NA | NA | NA | NA | 8.687*** | 8.624*** | 5.756*** | 6.261*** |
| NA | NA | NA | NA | NA | NA | NA | NA | (0.991) | (0.830) | (0.699) | (0.730) | |
| 2002§ | 5.882*** | 5.879*** | 4.181*** | 4.127*** | 15.797*** | 15.473*** | 16.787*** | 16.558*** | NA | NA | NA | NA |
| (1.224) | (1.135) | (1.035) | (1.006) | (0.993) | (0.948) | (1.258) | (1.287) | NA | NA | NA | NA | |
| Constant | 66.957*** | 69.485*** | 40.019*** | 39.049*** | 61.193*** | 61.739*** | 33.505*** | 30.280*** | 65.867*** | 64.718*** | 71.930*** | 82.350*** |
| (3.844) | (3.769) | (4.541) | (5.334) | (4.400) | (4.229) | (5.663) | (6.241) | (6.435) | (6.386) | (5.493) | (4.877) | |
| N | 1,044 | 1,046 | 1,039 | 1,041 | 1,040 | 1,042 | 1,032 | 1,034 | 1,032 | 1,032 | 645 | 645 |
| Within R2 | 0.25 | 0.25 | 0.15 | 0.15 | 0.62 | 0.62 | 0.43 | 0.43 | 0.48 | 0.47 | 0.48 | 0.47 |
Significant at 10%.
Significant at 5%.
Significant at 1%.
Bootstrapped standard errors based on 500 replications.
For Betablocker medication, diabetes hemoglobin A1c screening, diabetes eye exams, diabetes lipid screening, LDL cholesterol screening and diabetes nephropathy monitoring plans were allowed to rotate measures (2001 for diabetes measures, 2000 and 2002 for β-blocker medication, and 2002 for LDL cholesterol screening). All observations in years where plans were permitted to rotate were dropped from the analysis (and thus a “NA” is included for the year covariates).
HMO HHI, the number of HMOs, Hospital bed HHI, and HMO penetration rate were aggregated to plan level using MSA weights averaged over 1998–2002.
1999 is the omitted year.
HEDIS, Healthcare Effectiveness Data and Information Set; HHI, Herfindahl–Hirschman Index; HMO, health maintenance organization; NCQA, National Committee for Quality Assurance.