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NCQA To Measure PPO Care Quality

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The National Committee for Quality Assurance is expanding efforts to gauge how health plans affect members’ health.

The NCQA, Washington, says it now will require preferred provider organizations participating in its quality rating programs to provide the same information about patient experience ratings and clinical outcomes that health maintenance organizations provide.

In the past, managers of many PPOs have argued that they have less ability than managers of HMOs either to get patient health data or to influence patients’ health, but 80 PPOs already report full care quality data to the NCQA, the NCQA estimates.

Requiring PPOs to supply patient health data will make plans easier to compare and encourage PPOs to do more to improve patients’ health, NCQA officials argue.

The health plans that report NCQA high blood pressure results may have saved as many as 83,000 lives since 1999 simply by taking steps to improve their NCQA blood pressure results, NCQA officials estimate.