Washington-area health plans do better than most in screening women for cervical cancer and prescribing appropriate medicines for patients with asthma, but local plans lag in treating heart attack survivors and people with hypertension and diabetes, according to a new report.

Local plans "didn't do too badly" overall, said Margaret O'Kane, president of the National Committee for Quality Assurance (NCQA), a nonprofit accrediting organization that issued a report this week on more than 500 health plans nationwide. However, she added, their performance was often inconsistent: A plan that scored well on one measure might score poorly on another.

Kaiser Permanente, Cigna HealthCare and Aetna Health generally did better than their local peers in seven clinical performance areas -- adolescent immunizations, beta blocker treatment after heart attack, hemoglobin A1c testing for diabetes, high blood pressure control, asthma medication prescribing, and breast cancer and cervical cancer screenings.

UnitedHealthcare often was rated below average on the seven measures. Optimum Choice and M.D. IPA, both owned by UnitedHealth Group, also often trailed other plans. (UnitedHealth officials did not return calls seeking comment on the report.)

Kaiser, ranked lowest among local plans in prescribing appropriate medications for people with asthma, took issue with NCQA's assessment, suggesting that asthma should be treated differently from other bronchial conditions. "At Kaiser Permanente, we care more about the patients than the score," said Kaiser spokeswoman Amy Goodwin.

Likewise, Cigna was bested by others on screening for cervical cancer. While 79 percent of its non-elderly adult females had a timely Pap test, some plans had scores of about 83 percent.

Conversely, underperforming plans outgunned the competition occasionally. At 76 percent, for example, M.D. IPA scored high on the proportion of middle-aged women screened for breast cancer.

The area's biggest insurer, CareFirst BlueCross BlueShield, had mixed results on the seven measures. Its BlueChoice plan scored comparatively well on four standards but trailed on three: diabetes monitoring, breast cancer screenings and adolescent immunizations.

People who soon will choose their health insurance coverage for 2006 may want to get more details by visiting NCQA's www.healthchoices.org Web site. The results are also posted by U.S. News & World Report, NCQA's partner in the rating effort.

"Quality does matter," said O'Kane. "It varies a lot, and health plans can make a difference."

-- Christopher J. Gearon

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