Public policy must change before the National Committee for Quality Improvement can insist that health plans collect and report data that can be used to highlight disparities in care among racial and ethnic groups, according to an NCQA spokesman.
The response is directed at a Commonwealth Fund report that tries to nudge the NCQA and the Joint Commission on Accreditation of Healthcare Organizations into making such reporting a prerequisite to accreditation.
"We think it's a good idea and actually recommend that plans do it," says an NCQA representative, Brian Schilling, "but we're a ways away from being able to incorporate that into the accreditation program. There are legal issues. Because of antidiscrimination laws, it would be illegal for health plans to do it in certain states. There is a broad public policy issue that has to be addressed before anybody can move ahead."
The Commonwealth Fund report, based on information collected from eight managed care plans that were involved in a demonstration project, also suggests that standards be developed to indicate what magnitude of disparity should be cause for concern.
"As the body of evidence on racial and ethnic health care disparities grows, health care leaders are eager to take concrete actions to eliminate disparities," says Karen Davis, president of the Commonwealth Fund. "Standards for collection and reporting of these data will allow health plans to design programs and practices that will improve quality of care for all patients."
Schilling points out that even if the public policy issues are addressed, there are other obstacles.
"Just in terms of collecting it by race is obviously more burdensome than just collecting it overall," says Schilling. "Also, there are operational issues. How do you do it, exactly?"