HMO cancer screenings below national average

Thursday, Aug. 15, 2002 | 9:28 a.m.

CARSON CITY -- Nevada's health maintenance organizations ranked below the national average in 2001 in quality in breast and cervical cancer screening and providing routine care and examinations for children.

But there was good news in the annual report for 2001, to be presented to the state Board of Health on Friday in Las Vegas. The state's seven HMOs improved from the previous year in the seven categories surveyed, and they were at the national average in adults who receive preventive and ambulatory services.

The report was compiled by the state Bureau of Health Planning and Statistics from data supplied by seven of the state's HMOs: Aetna U.S. Healthcare, Health Plan of Nevada, HMO Nevada, Hometown Health Plan, NevadaCare, St. Mary's Health First and PacifiCare. All are based in Las Vegas except Hometown Health and St. Mary's, which are in Reno.

The survey was prepared by health resource analyst Tina Perry, data analyst William Lee and state biostatistician Dr. Wei Yang.

The report said 67 percent of Nevada women ages 52 to 69 enrolled in HMOs had a mammogram to detect breast cancer in 2001. The national average was 74 percent, and all seven HMOs fell below that mark. Still, Nevada's rate increased by 2 percentage points from 2000.

The state's HMOs didn't do much better on cervical cancer, the fourth leading type of cancer among Nevada females.

Seventy-five percent of women 21 to 64 years old received a screening during a two-year period, and the national average was 78 percent. St. Mary's Health First scored 79 percent, a point above the national figure, and Aetna equaled the national rate at 78 percent. The other five were below the national level.

The state's HMOs also trailed the nation in three other areas the survey measured:

The report said children who do not access preventive health care have a higher likelihood of developing advanced and preventable diseases.

Hometown Health Plan at 21 percent, St Mary's at 22 percent and PacifiCare at 23 percent were below the national average.

After concerns were raised that Caesareans were performed excessively, the numbers started to decline in the early 1990s, but have started rising again. The report said the increase "may be a direct effect of research and publications of the risks and complications of vaginal birth after a Caesarean section," the bureau said.

Studies showed there may be a risk of a uterine rupture for women who undergo vaginal birth after a Caesarean section, said the report. HMOs reported they expect Caesarean sections to rise in the future.

The state's HMOs did better in preventative health care for adults, resulting in fewer emergency room visits than the national average, the report said.

In Nevada 92 percent of the HMOs' adult patients got preventive health care, even with the national average. Three HMOs -- St. Mary's at 94 percent and Hometown Health and Health Plan, both at 93 percent -- exceeded the national average.

Adults who "do not access preventive health care have a higher likelihood of developing preventable or advanced diseases at a higher personal and financial cost," the bureau said.

The high percentage of preventive care showed in the state's use of emergency rooms.

Members of HMOs in Nevada visit emergency rooms less than their counterparts nationally. There were 122 emergency room visits per 1,000 persons in Nevada, compared with the national average of 164. Five of the seven plans were below the national average. St. Mary's with 176 visits and HMO Nevada with 173 were above the national average.

The report shows Nevada's averages improved in all seven indicators from the 2000 rates.