April 7, 2006

NCQA Hails New OPM Quality Reporting Requirement
for PPO Plans Serving Federal Employees

HEDIS® information on cancer screenings, cholesterol and diabetes will help save lives and enhance productivity

WASHINGTON—NCQA today applauded the U.S. Office of Personnel Management (OPM) for requiring its fee-for-service plans offering preferred provider organizations (PPOs) to collect and report quality performance measures. The step means 8 million federal employees, dependents and retirees will soon have better comparative information with which to make important health coverage decisions.

For 2007, OPM will require all fee-for-service plans covering federal workers to measure and submit data from five clinical quality measures covering breast cancer screening, cholesterol testing, and diabetes care.

“As the nation’s largest employer, the federal government has made a very powerful statement that every American needs good, comparable information about health care quality, regardless of the type of health plan they choose,” said NCQA President Margaret E. O’Kane. “When fee-for-service plans start reporting HEDIS data, for the first time federal workers will be able to determine which plans offer them the greatest value, and help keep their families the healthiest.”

Data from NCQA’s 2005 State of Health Care Quality Report demonstrate that performance measurement serves as a catalyst for quality improvement. For example, over the last five years, plans reporting data have improved blood pressure control by 15 percentage points, resulting in 8,600 to 15,000 lives saved each year.
OPM’s decision, combined with an earlier decision by the Medicare program to require PPOs to report an even broader number of HEDIS measures, is a strong signal to the health care industry that Americans must receive more information about the performance of the health plans, doctors, and hospitals on which they rely. NCQA is working with health plans around the country to increase performance reporting by PPOs, which currently provide health insurance coverage to some 185 million Americans.

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.