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Life Health > Health Insurance > Life Insurance Strategies

NCQA Asks PPOs To Supply HEDIS Figures

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The National Committee for Quality Assurance wants preferred provider organizations to report on members’ mammogram rates and childhood immunization rates.

The NCQA, Washington, is setting up a new Health Plan Accreditation standards program.

The new HPA program will require participating PPO plans to report the same Healthcare Effectiveness Data and Information Set performance figures that participating health maintenance organizations have been reporting for more than a decade, the NCQA says.

In the past, PPO administrators have argued that PPO plans’ decentralized nature makes gathering HEDIS data difficult and makes interpreting the data even more difficult.

But Medicare and the Federal Employees Health Benefits Program now require PPOs to report HEDIS data, the NCQA says.

The list of organizations supporting the combined HMO/PPO accreditation program includes Independence Blue Cross, Philadelphia, a nonprofit health insurer.


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