NCQA Compares Plans On Chronic Disease


The National Committee for Quality Assurance plans to offer a snapshot based on its well-known HEDIS report that it hopes will let employers and workers get a quick, but comprehensive, view of how health plans handle four chronic diseases.

Plan-specific results on as many as 13 HEDIS measures for diabetes, cardiac conditions, asthma, and mental illness will be added to NCQA's Living With Illness reports. This new drill-down feature was added to NCQA's Health Plan Report Card recently with 2003 HEDIS results; 2004 data will be made available in September.

"We chose diabetes, heart disease, asthma, and mental illness because they are conditions for which good care means the right screening, the right care, and the right follow-up," says NCQA spokesman Jeff Van Ness. "There's also enough evidence in the literature so that NCQA has been able to develop reliable measures that define what the right care is."

Van Ness points out that this is the public release of clinical performance data. Health plans know well in advance how they're doing, and what they may have to do to perform better.

"Employers are among the biggest supporters of the new reports," says Van Ness. "Through our Purchaser Advisory Council, many were closely involved in the reports' development. Ultimately, the drill-downs in the Living With Illness reports are likely to be used most frequently by employers making contracting decisions — although we'd love to see widespread use of the reports by consumers to inform their decision-making during open enrollment."

Consumer groups, if not individual consumers, are excited. "One of the most valuable tools for a patient with chronic illness is good information," says Debra Ness, president of the National Partnership for Women and Families. "A consumer selecting a health plan will find the Living With Illness reports to be an invaluable resource." To view a sample report, visit «www.ncqa.org/Programs/Accreditation/MCO/lwir.htm/».

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