March 4, 2004

NCQA LAUDS RECOMMENDATIONS FOR MEDICARE PAY-FOR-QUALITY

MedPAC report endorses use of financial incentives to enhance quality, prevention

WASHINGTON- The National Committee for Quality Assurance (NCQA) today applauded the Medicare Payment Advisory Commission (MedPAC) for highlighting the need to create financial incentives for quality improvement in the Medicare program. The report highlights the fact that Medicare payments currently bear little or no relation to quality. While several programs are in place to improve quality, including public reporting, accreditation, and conditions of participation, most currently have little to no bearing on financial compensation.

“Currently, Medicare pays everyone the same no matter how good, or poor, the quality of the care they deliver,” said Richard Sorian, NCQA Vice President for Public Policy. “By moving to a system that rewards quality, we can drive the kind of improvement Medicare beneficiaries deserve.”

NCQA is involved in a number of projects aimed at rewarding quality and creating incentives for quality improvement. These include:

• Bridges to Excellence, an employer-sponsored program that provides bonuses to physicians who meet the quality standards of the American Diabetes Association/NCQA Diabetes Physician Recognition Program (DPRP) and the American Heart Association/American Stroke Asoociation/NCQA Heart/Stroke Recognition Program (HSRP).
• The Integrated Healthcare Association’s Pay For Performance (P4P) initiative, which provides incentive payments to physician groups that meet performance measures developed by NCQA.

In 2003, NCQA’s State of Health Care Quality report identified payment systems that reward excellence as a key factor in closing the “quality gap” in health care. Most evidence gathered suggests that linking pay with performance results in improvements across a broad range of clinical and member satisfaction measures.

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.

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