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NCQA prepares to grade ACOs

By Allison Bell

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A top player in the health plan quality assessment market is comparing measures it could use to rate the quality of accountable care organization (ACO) programs. The National Committee for Quality Assurance (NCQA) is conducting tests to see what kinds of data ACOs can create and what kinds of quality measures might work well in the real world.

The NCQA hopes to report on the performance of the performance benchmarks through a webinar this fall. The study includes the ACO measures already required by the two big Centers for Medicare & Medicaid Services (CMS) ACO programs.

The NCQA is also looking the measures it applies to health maintenance organization (HMO) plans and preferred provider organization (PPO) plans through the HEDIS performance reporting system.

HEDIS uses many different kinds of measures, such as blood pressure screening rates and hospital patient readmission rates. The NCQA and another organization, URAC, already accredit ACOs.

An ACO is a group of health care providers that agree to share responsibility for managing and providing a patient’s care. The ACO is supposed to assume at least some of the financial risk involved with providing the care, to give the providers an incentive to deliver the care as efficiently as possible.

Analysts at Oliver Wyman recently reported that about 25 million U.S. residents may be getting care through ACOs, and that 45 percent of U.S. residents may live in regions served by at least one ACO.