September 9, 2005
NCQA’s O’Kane Calls on Congress to Push Medicare Pay-for-Performance
National Committee for Quality Assurance (NCQA) President Margaret E. O’Kane today called on Congress to support the broad adoption of pay-for-performance programs within Medicare. The Medicare program has several pilot pay for performance efforts underway and the Medicare Payment Advisory Committee (MedPAC) is a strong supporter of expanding pay for performance throughout the system. Congressional support, though, is essential to moving these and other such programs into widespread use in Medicare.
In testimony delivered today to MedPAC, Ms. O’Kane noted that pay for performance programs in the private sector have led to substantial quality improvements and cost savings of between 10% and 15%. Broad adoption of pay for performance at all levels of the Medicare system – among doctors, medical groups, hospitals and Medicare Advantage health plans –could be expected to yield similar benefits.
CMS currently requires all Medicare Advantage plans to annually report on their clinical performance using NCQA’s HEDIS (Health Plan Employer Data and Information Set) measures. Ms. O’Kane called on Congress to build pay for performance programs around this established activity.
NCQA offers three “Physician Recognition” programs that serve as the foundation for various pay-for-performance efforts at the physician level. Together with the American Diabetes Association and the American Heart Association/American Stroke Association, NCQA offers programs that highlight doctors who provide diabetes, cardiac and stroke care that is consistent with evidence-based standards. The employer-led Bridges to Excellence program and many health plans offer financial incentives to doctors who meet the NCQA criteria in these areas. NCQA also offers a recognition program for physicians and medical groups that adopt information technology to help improve care.
MedPAC has previously praised NCQA’s physician-level assessment programs. In an earlier report, MedPAC singled out NCQA’s Physician Practice Connections program – which recognizes doctors and medical groups that adopt information technology to help improve care – as a good model for future pay for performance efforts.
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and manages the evolution of HEDIS, the tool the nation’s health plans use to measure and report on their performance. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health care choices.