Offering credible, easy-to-understand health insurance quality indicators could be critical to efforts by the new health insurance exchanges to hold the cost of coverage down.
Officials at the National Committee for Quality Assurance (NCQA), Washington, make that case in a revised version of a presentation explaining to the National Association of Insurance Commissioners (NAIC), Kansas City, Mo., why the NCQA thinks providing quality data should be an important part of the exchange program that is supposed to be created by the Patient Protection and Affordable Care Act of 2010 (PPACA).
If PPACA takes effect as written and works as expected, exchanges are supposed to begin offering individual and small group policies that meet minimum federal value standards starting Jan. 1, 2014.
Consumers with incomes ranging from 133% to 400% of the federal poverty level will be able to use the exchanges to buy coverage using a new system of federal income tax credits, but the U.S. Department of Health and Human Services (HHS) says it will let states design the exchanges how they see fit.
The NAIC’s Exchanges Subgroup was going to hold a session in August at the association’s summer meeting in Philadelphia. NAIC canceled the meeting because of concerns about Hurricane Irene.
The subgroup is set to return to the topic Saturday, and the NAIC’s fall meeting in National Harbor, Md.
NCQA officials suggested in the original version of the exchange presentation that the exchange design effort is an opportunity for policymakers to use “choice architecture” to nudge consumers toward the health insurance options that offer the most bang for the buck.
Choice architecture could include strategies such as building portal displays that array cost and quality information together and providing decision-support tools that highlight quality as well as cost, NCQA officials.
In the new version of the presentation, NCQA officials again talk about the importance of choice architecture. They put more emphasis on the need for the kinds of formal quality measurement and accreditation programs that the NCQA providers.
“Accreditation is meaningful,” NCQA officials say. “[A] rigorous program can drive value.”
If no quality data are available from a comparison shopping website, “consumers high cost is a proxy for high quality,” the NCQA officials say. “If quality data are provided with cost [data], consumers will choose high-value (low-cost, high-quality) [options].”