The Quality Plus program was designed with three specific goals:
- Set the stage for a new generation of NCQA programs designed with the broad range of current health plan offerings in mind. More and more Americans enroll every year in consumer-directed health plans and other coverage models that did not exist only a few years ago. And HMOs, preferred provider organizations (PPOs) and other plan types are engaging in new strategies and new functions (care management, Web-based customer support, physician-level measurement) that were uncommon when the current NCQA Accreditation model was developed. Through Quality Plus, NCQA will introduce standards and measures that will allow us to evaluate these new functions in a standardized way across different types of organizations.
- Drive measurement and reporting at the physician and hospital level of the system. Performance measurement is an effective way to improve quality. And there is no doubt that consumers put a high value on reliable information about physician and hospital quality. As consumers are increasingly called upon to make more and more of their own health care decisions (as in the case of consumer-directed plans), the need for physician and hospital level information becomes even more apparent. Pay-for-quality programs, another proven strategy for promoting quality, also rely on measurement at the physician and hospital level.
- Enable consumers and employers to make comparisons among different types of plans. Our health care system provides choice. One basic choice consumers and employers must make is between different available coverage options – HMO, PPO, consumer-directed plan, etc. By introducing new measures and standardizing the kinds of information that are available about different types of organizations, Quality Plus will make it easier for consumers to compare their options and recognize which represents the best value. Value is a function of both cost and quality, and some of the new requirements being introduced will evaluate how these attributes balance. Information about value is extremely powerful. In markets where information about value is readily available, buyers tend to gravitate toward higher quality, lower cost products. Absent such information, market and other forces can actually drive prices higher and undermine quality. Such is often the case with health care.