AP Online - Sept. 27: Washington - The quality of the health care provided to millions of Americans improved last year across several dozen categories, including increased immunization rates among insured children.The improvements are seen through the reporting of data that the White House and Congress want more of from health-care providers. They're contained in a report being issued Wednesday by the National Committee for Quality Assurance, which accredits and certifies insurers.The association tracks dozens of care measurements, submitted by many of the nation's insurance plans. The long-term tracking of the measurements helps improve the quality of care, according to the report.For patients in private insurance plans, there was improvement in 35 of 42 measurements, including such categories as cervical cancer screening, colorectal cancer screening and the controlling of high blood pressure in hypertension patients.Categories that showed a decrease in the quality of care included breast cancer screenings. The percentage of women in commercial insurance plans, ages 50-69, who got a breast cancer screening in the past two years dropped to 72 percent from 73.4 percent. Similar drops were seen in insurance plans covering Medicare and Medicaid patients.The gains also include increased numbers of children with private health insurance getting all their recommended immunizations, with the rate reaching 77.7 percent, up from 72.5 percent. Also, more smokers enrolled in Medicare received advice about kicking the habit.From year to year, many of the changes are small often just a percentage point or two. But the differences come into clearer focus over a 10-year period, officials said.For example, the committee said that more than 96 percent of patients who suffered heart attacks last year were given drugs to lower their blood pressure and slow the heart rate, which helps prevent a second attack. A decade ago, about 62 percent of patients suffering heart attacks were given such medicines.One in four Americans are enrolled in health plans that collect and report data on the quality of care. However, more than 100 million Americans are enrolled in plans that report no objective quality data, the report said."This past decade has demonstrated the benefits of measurement, reporting and accountability, but three out of four people don't enjoy those benefits today," said Margaret E. O'Kane, the president of the National Committee for Quality Assurance. "It's time to ask, 'Why not?'"The committee noted that one important exception to a pattern of improvement was the quality of care for Americans with mental health problems. Patients in insurance plans who are hospitalized for mental illness are only marginally more likely to get appropriate follow-up care than they were when the insurers began collecting quality data in 1998.