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Life Health > Health Insurance

NCQA Quality Participation Numbers Mixed

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NU Online News Service, Sept. 7, 12:33 p.m. – The National Committee for Quality Assurance, Washington, is reporting a modest rebound in the number of managed care plans participating in its latest quality report.

The nonprofit group persuaded 372 health plans covering 63 million people to submit quality data for its fifth annual quality report.

Participation is still down from the 1999 report, which gave data for 410 plans covering 70 million people, possibly because of consolidation in the managed care industry. But participation is up in terms of the number of plan members enrolled in the participating plans.

The 2000 report quality gave data for 466 plans, but the participating plans covered only 51 million people.

Managed care companies and large employers started NCQA in the early 1990s, to come up with free-market approaches to improving health plan quality and ward off quality laws and regulations that might stifle innovation. Many states now require health plans doing business in their state to participate in NCQA quality programs or comparable programs organized by other groups.

Participating plans reported particularly strong gains on indicators dealing with treatment of acute physical illnesses, such as the rate of cholesterol screenings given after heart attacks. But other indicators dealing with chronic physical illnesses and mental illnesses, which had been slow to improve in past years, also improved.

The percentage of diabetic members of reporting plans receiving annual retinal eye exams increased to 48%, from 45%, for example.

NCQA notes, however that participation in the survey is voluntary and participating plans have some choice about the indicators they choose to report in a given year. Plans with poor results on a particular indicator may choose to skip that indicator, or drop out of the quality reporting program.

“For two years in a row, we’ve seen that participating health plans are getting better,” Margaret O’Kane, NCQA president, said in a statement. “The rest of health care is still a real question mark.”


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