URAC will start by looking at variables such as patient satisfaction and availability of provider price information, rather than patient health, when it introduces a new set of health care management quality indicators.
URAC, Washington, manages accreditation programs for health plans, health networks and other health care organizations.
In September 2006, URAC asked members of the public for comments on a proposal to create a new set of service quality indicators.
URAC has decided that the resulting Consumer Value Based Health Purchasing Measures project will apply to all URAC accreditation programs, URAC officials say.
The National Committee for Quality Assurance, Washington, has developed a quality assessment program for health maintenance organizations and some preferred provider organizations that emphasizes indicators such as the percentage of plan members who have received recommended cancer screenings and the percentage of members with diabetes who have kept blood sugar levels under control.
Instead of emulating the NCQA program, organizers of the new CVBHPM program will "initially collect relevant information about consumer protection and empowerment and quality data for comparison across 3 general categories: service quality, consumer protection and empowerment, and satisfaction with services," URAC officials say.
The program will start with 3 principles:
- Performance measures should address dimensions of health plan performance that the consumer values–specifically those that concern consumer choice.
- Performance measures should target results that health plans are accountable for and have the ability to influence.
- Performance measures should be based on data that can be collected and reported in a consistent fashion across the continuum of health benefit plans.
The CVBHPM will be phased in over several years, and URAC will release only total industry data during an initial 2-year measurement and reporting period, URAC officials say.
"URAC will later consider whether, with the consent and cooperation of participating organizations, to report individual company data to the public," URAC officials say.
Measures included in the program could include client and consumer satisfaction rates; complaint rates; availability of specific provider price and quality information; and use of quality incentives, officials say.
URAC decided not to focus on clinical indicators because it wants to emphasize assessment of areas that participating organizations have a direct ability to influence, officials say.
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