April 26, 2006

New NCQA Program Will Help More Than 20 Million Compare Doctors and Hospitals on Quality and Cost

47 health plans commit to Physician and Hospital Quality standards

WASHINGTON—The National Committee for Quality Assurance (NCQA) today announced that 47 health plans, including five preferred provider organizations (PPOs), covering more than 20 million Americans, have committed to measure the quality and cost of the care provided by their network physicians and hospitals, and to be evaluated on how well they communicate the results to their customers. Reviews against NCQA’s new Physician and Hospital Quality standards will begin this summer and continue throughout 2006.

The standards have received broad-based support from employers, purchaser coalitions, and health care advocacy organizations.

“Consumers and employers can access a wealth of comparative information when they need to make other important decisions, such as home and car purchases and investment options. They deserve no less to guide their health care choices,” said NCQA President Margaret E. O’Kane. “The health plans that have committed to participate in Physician and Hospital Quality are sending a strong signal to their members—and employers—about their commitment to expanding transparency and accountability in health care.”

EARLY ADOPTERS OF PHYSICIAN AND HOSPITAL QUALITY STANDARDS
1. Aetna Health of California, Inc.
2. Anthem Blue Cross and Blue Shield - Connecticut
3. Anthem Blue Cross and Blue Shield in Indiana (PPO)
4. Anthem Blue Cross and Blue Shield in Kentucky (PPO)
5. Anthem Blue Cross and Blue Shield of Ohio (PPO)
6. Anthem Health Plans of Maine
7. Anthem Health Plans of New Hampshire
8. Blue Choice (Mo.)
9. Blue Cross and Blue Shield of Massachusetts, Inc.
10. Blue Cross Blue Shield of Minnesota (PPO)
11. Blue Plus (Minn.)
12. Blue Shield of California
13. CIGNA HealthCare Mid-Atlantic, Inc.
14. CIGNA HealthCare of Arizona, Inc.
15. CIGNA HealthCare of California, Inc.
16. CIGNA HealthCare of Colorado, Inc.
17. CIGNA HealthCare of Connecticut, Inc.
18. CIGNA HealthCare of Delaware, Inc.
19. CIGNA HealthCare of Florida, Inc.
20. CIGNA HealthCare of Georgia, Inc.
21. CIGNA HealthCare of Illinois, Inc.
22. CIGNA HealthCare of Indiana, Inc.
23. CIGNA HealthCare of Kansas/Missouri, Inc.
24. CIGNA HealthCare of Maine, Inc.
25. CIGNA HealthCare of Massachusetts, Inc.
26. CIGNA HealthCare of New Hampshire, Inc.
27. CIGNA HealthCare of New Jersey, Inc.
28. CIGNA HealthCare of New York, Inc.
29. CIGNA HealthCare of North Carolina, Inc.
30. CIGNA HealthCare of Ohio, Inc.
31. CIGNA HealthCare of Pennsylvania, Inc.
32. CIGNA HealthCare of South Carolina, Inc.
33. CIGNA HealthCare of St. Louis, Inc.
34. CIGNA HealthCare of Tennessee, Inc.
35. CIGNA HealthCare of Texas, Inc.
36. Compcare Health Services Insurance Corporation (Wis.)
37. Fallon Community Health Plan (Mass.)
38. Health Net of California
39. HealthPartners, Inc. (Minn.)
40. HIP Health Plan of New York
41. Horizon HMO (N.J.)
42. Massachusetts Health Quality Partners*
43. Medica (Minn., S.D., Wis.)
44. Minnesota Community Measurement Collaborative*
45. MVP Health Plan, Inc. (N.Y., Vt.)

* denotes measurement collaborative
Health plans seeking distinction in Physician and Hospital Quality must show that they measure the quality and cost of network providers through the use of clinical measures of physician quality endorsed by the National Quality Forum (NQF) and the Ambulatory Care Quality Alliance, and hospital quality measures endorsed by NQF and the Hospital Quality Alliance. Plans must use results about both cost and quality, whenever possible, to improve the quality of services delivered, and share the data with their customers.

Physician and Hospital Quality is the third area in NCQA’s Quality Plus program, which allows health plans to achieve voluntary distinction by meeting tough new standards before they become mandatory. The first two content areas, Member Connections and Care Management and Health Improvement, were released in 2005 and have received broad support from health plans, employers and consumers; to date, more than 125 surveys on the first two content areas have been scheduled.

The new program also allows measurement collaboratives—initiatives comprising several health plans, often with the participation of medical groups and purchasers—to come forward for review under the program. Two such collaboratives, the Minnesota Community Measurement Collaborative and Massachusetts Health Quality Partners—have committed to participate in the program.

CIGNA Health Care has volunteered its managed care organizations for review under the Physician and Hospital Quality standards. “CIGNA HealthCare is committed to providing its members with actionable, reliable information they can use to make decisions about their doctors and hospitals based on quality. We believe this is an important next step forward in engaging our members in making good decisions about their heath care,” said Jeffrey Kang, MD, chief medical officer for CIGNA HealthCare. “Our support for this program shows our dedication to helping our members make appropriate comparisons about health care quality.”

EMPLOYERS AND EMPLOYER COALITIONS ENDORSING PHYSICIAN AND HOSPITAL QUALITY
- 3M Company
- The Boeing Company
- Bridges to Excellence
- Buyers Health Care Action Group
- California Public Employees'
Retirement System (CalPERS)
- Carlson Companies
- Cleveland State University
- DaimlerChrysler Corporation
- Eastman Chemical Company
- Ford Motor Company
- General Electric Company
- General Motors Corporation
- Human Resources Policy Association
- Kellogg Company
- Kennametal Worldwide
- Marriott International
- MidAtlantic Business Group on Health
- Midwest Business Group on Health
- National Business Coalition on Health
- National Business Group on Health
- New York Business Group on Health
- Pacific Business Group on Health
- St. Louis Area Business Health Coalition
- SYSCO Corporation
- UPS
- Wells Fargo & Company
- Xerox Corporation 
CONSUMER AND HEALTH POLICY ORGANIZATIONS ENDORSING PHYSICIAN AND HOSPITAL QUALITY
- American Hospice Foundation
- Childbirth Connection
- Community Health Foundation of
    Western and Central New York
- Consumer-Purchaser Disclosure
    Project
- Consumers' CHECKBOOK/Center for
    the Study of Services 
- International Association of
    Machinists and Aerospace Workers
- Leapfrog Group
- National Coalition for Cancer
     Survivorship
- National Partnership for Women and
     Families 
Plans noted the standards’ emphasis on collaboration and transparency. “Meeting the Physician and Hospital Quality standards shows that we’re setting the pace in helping our members make reliable comparisons and informed decisions when it comes time to pick a doctor or a hospital,” said Gifford Boyce-Smith, M.D., Senior Medical Director, Quality Management, Blue Shield of California. “Using standardized quality and resource use measures will go a long way towards making health care more transparent for both patients and purchasers. Until it happens, it’s tough to overstate what a difference this will make.”

The first surveys on the new Physician and Hospital Quality standards will begin as soon as July 1. Decisions on Physician and Hospital Quality surveys will be issued as early as the fourth quarter of 2006; plans achieving distinction will be listed on NCQA’s Health Plan Report Card at http://www.healthchoices.org/. Plans interested in scheduling surveys on the new standards or participating in a Web-based seminar to learn more about the program are encouraged to visit NCQA’s Web site at http://www.ncqa.org/.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations, recognizes physicians and physician groups in key clinical areas 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.