NCQA TO EXPAND PHYSICIAN AND HOSPITAL QUALITY PROGRAM
Proposed changes would make more plans eligible; public comment through April 1

WASHINGTON—The National Committee for Quality Assurance today released for public comment updated standards for Physician and Hospital Quality (PHQ), a program that evaluates how well health plans measure and report the quality and cost of physicians and hospitals. The proposed changes would make the program available to accredited and nonaccredited health plans and add new requirements to respond to demand from employers and regulators across the country.  The comment period will run through April 1.

“Provider quality will only improve when measurement is based on trustworthy information,” said NCQA President Margaret E. O’Kane. “Consumers and employers must be able to rely on the information that's published about their doctors and hospitals or used to design networks.”

Efforts to measure physician and hospital performance have increased over the past several years—as have concerns about the validity of their measurement. PHQ serves as an impartial third-party certification of the credibility of physician measurement programs. Since its launch in 2006, 38 NCQA-Accredited health plans have met the standards.

“Providing our members with information about physician performance empowers them to become smarter health care consumers,” said Troyen Brennan, MD, Aetna’s Chief Medical Officer. “The PHQ seal is external validation that information about providers is developed and measured fairly and accurately.” 

The updated standards are more explicit about how plans involve physicians and consumers in measurement programs. They require plans to use standardized measures such as those endorsed by the National Quality Forum, a government agency or the AMA-convened Physician Consortium on Performance Improvement. They require plans to consider quality, and not just cost, when they act on measurement results.

“Any responsible physician measurement program has to engage physicians at every step. This includes input during the development process and relevant, actionable feedback that doctors can use to improve care,” said Richard J. Baron, M.D., FACP, President, Greenhouse Internists, PC. “Using standardized quality measures in a transparent, understandable way is the difference between measuring who’s best and who’s simply the least expensive.”

Members of the public are invited to comment on the draft Physician and Hospital Quality standards through April 1. Details and instructions are posted on the NCQA Web site at www.ncqa.org. The final PHQ requirements will be published in July 2008.

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 recognizes physicians in key clinical areas. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care.  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. For more information, visit http://www.ncqa.org/.