June 29, 2004

PICTURE ON DOCTOR QUALITY CLARIFIES AS NCQA DATA ON PHYSICIANS BECOMES MORE WIDELY AVAILABLE

New Web tool to help consumers identify doctors recognized for excellent diabetes, cardiac, stroke care; separate arrangement with GeoAccess to put recognition information in directories nationwide

WASHINGTON — NCQA announced today that a new online tool and a separate arrangement with the GeoAccess division of Ingenix, a leading supplier of physician directory information, will make NCQA-supplied information about doctor quality readily available to tens of millions of consumers. The forthcoming data on doctor quality are drawn from physician recognition programs in the areas of diabetes and cardiac/stroke care. To earn recognition, physicians must meet rigorous quality and performance standards.  Historically, little such information has been available. 

“For the past 100 years, people have chosen their doctor based on reputation, location, word of mouth, even last name – everything except objective data on the quality,” said NCQA President Margaret E. O’Kane. “That era is coming to a close. NCQA Physician Recognition data are rapidly being incorporated into the physician directories and Web sites people use to select their doctors. As a result, you’re going to see people making better choices and gravitating toward recognized doctors.”

The new, searchable database added to NCQA’s Web site today allows visitors to search for a physician by area of expertise, location and other criteria. For example, a person looking for a physician with special expertise in treating diabetes in Winston- Salem , North Carolina could quickly enter this information and receive a listing of all 36 physicians in the area who meet those criteria.  Physicians with dual recognition – both diabetes and heart/stroke recognition – are clearly identified. The database also includes contact information and, for many physicians, a picture, practice history, education, office hours, directions and other information to assist consumers.   

The database fills a long unmet need in health care. “Information about physician quality fills a real void in the market,” said Debra Ness, Vice President, National Partnership for Women and Families. “Consumers ask for it more often than for any other kind of information.”

Enabling consumers to select among physicians based on quality has far-reaching implications for the health care system. It will reward those physicians who deliver good care and pressure others to improve.  Such pressure may help resolve longstanding quality-related issues in health care. For example, a recent study reported that patients have only a 50% chance of getting the right care for any given ailment. In 2000, it was reported that up to 98,000 Americans die every year as a result of medical errors.   

NCQA’s new searchable database reflects many of the recommendations for physician directory format and content released last year by an expert panel funded by the Commonwealth Fund.  The panel’s recommendations offer guidelines on how to make such directories easy to use and informative and on how to ensure that they are up-to-date.

Information about individual physicians is available courtesy of two Physician Recognition programs developed by NCQA and its partners, the American Diabetes Association and the American Heart Association/American Stroke Association.  These programs measure how consistently doctors provide certain key screenings, or how able they are to control their patients’ key metabolic indicators such as blood pressure or cholesterol.  Doctors who meet program thresholds are “Recognized,” a status which many doctors emphasize in marketing or advertising efforts.  NCQA, AHA/ASA and the ADA also refer patients to recognized doctors several thousand times a month.    

To ensure that consumers have access to recognition data via means other than the NCQA Web site, NCQA also recently arranged with GeoAccess to allow the firm to include RP program data in the online physician directories it manages for hundreds of health plans and major employers.  These physicians, then, might be highlighted in the directories or identified with a star, checkmark or other asterisk by their names. Health plans that already highlight recognized physicians in their network directories include Aetna , CIGNA, Medical Mutual of Ohio and UnitedHealthcare.

“Health plans have a strong interest in encouraging their members to see the best possible doctor in their network for any given condition and this information helps them do just that,” said Paul Weaver, Chief Executive Officer, GeoAccess. “And health plan members have the same interest – if you have diabetes and a doctor in your network has a star next to her name indicating that she does a good job treating diabetes, that’s really valuable information.”
 
Some health plans, such as the million-member Oxford Health Plan in New York, are helping their physicians seek recognition and offering an annual reward to recognized physicians. "At Oxford, we expect this effort to help us build strong relationships with our members and physicians," said Donald Stangler, MD, Vice President, Quality Management & Best Practices for Oxford Health Plans. "Highlighting recognized doctors helps us to ensure that our members get the best care possible, and rewarding our doctors for earning recognition shows that we have a serious commitment to the ADA guidelines and their efforts to practice high quality medicine."
 
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 offers recognition programs for physicians and physician groups. NCQA also manages the evolution of HEDIS, the tool used by most health care organizations to measure and report on their performance on key aspects of care and service. NCQA makes health care quality information available free of charge through the Web and media in order to help consumers and employers make informed health care purchasing decisions.

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