1996: NCQA releases Quality Compass®, the first national database of HEDIS information.
July 9, 2015 · NCQA
25 for 25: A series of 25 blog posts marking NCQA’s 25th anniversary. As part of our anniversary celebrations, NCQA will post a series of 25 blog posts highlighting milestones in our 25 years of improving health care quality.
“A woman with a high-risk pregnancy was ordered hospitalization by her doctor. The doctor feared a repeat of the women’s earlier pregnancy when he had to order a cesarean delivery after the fetus went into distress at 36 weeks. The woman’s HMO denied the request for hospitalization for the 2nd pregnancy on the grounds that it wasn’t necessary. The company instead authorized home nursing visits. When no nurse was on duty at the woman’s home, the fetus went into distress and died.” (American Journal of Public Health, June 1996)
Would this story make you nervous about picking a health plan? That would be a natural response. Would you question what your health maintenance organization (HMO) says you can and cannot do?
In 1996, these stories were the norm. There were limited ways to know the quality of the health care you were receiving. There were woefully insufficient ways to know what you could expect from your HMO. While the National Committee for Quality Assurance (NCQA) had begun efforts to equip health care consumers and employers with more information to choose a plan, it was clear there was an opportunity to do more. For many, picking a health plan still was the equivalent of pulling one out of a hat.
Needless to say, many consumers were scared. What if the health plan they picked led to irreversible care decisions? NCQA stepped in to provide our solution, a database that would help compare and contrast how health plans perform. Quality Compass was introduced in 1996 as a way to guide consumers as they pick the health plan that best meets their needs and provides high quality care.
At about the same time, other organizations such as Consumer Reports, Newsweek and U.S. News & World Report began to release their own critiques of HMOs. NCQA President Margaret E. O’Kane welcomed the critical mass. At the time, she said it was “a sign that people are looking for something” to guide them through the selection process.
What made NCQA’s Quality Compass stand out though, was its ability to reference national averages for certain measures, and compare those averages to an individual plan’s performance. The tool also compiles its information from two sources: NCQA’s Accreditation Program and performance reports based on the Healthcare Effectiveness Data and Information Set (HEDIS®). This allows consumers to access the most comprehensive data on health plan quality.
NCQA hoped Quality Compass would arm the consumer with the information he or she needs to have a knowledgeable conversation with administrators of their managed care plan. The response was notable: the Hospitals and Health Networks published a story on Quality Compass, stating that “within a few years, consumers will be able to shop for a health plan almost as easily as they can pick up a loaf of bread.”
Organizations representing consumers certainly welcomed Quality Compass too. A representative from the Consumer Coalition for Quality Health Care applauded NCQA “for its commitment to informed choice” when Quality Compass was released.
“Quality Compass holds the promise of becoming an important tool in guiding consumer selection of health care plans and moving us closer to the ultimate goal of holding all plans accountable for maintained and improving the health status of their enrolled populations,” said Consumer Coalition representative, Andrew Webber.
19 years after it was introduced, this tool continues to point consumers in the right direction for their health care needs. 391 commercial health plans covering roughly 102 million people were included in Quality Compass 2014.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
A cornerstone of NCQA’s 25th anniversary year will include a look ahead through the eyes of tomorrow’s leaders. This November 9, NCQA will convene Quality Talks: Inspiring the Future of American Health Care, a “TED-style” symposium held at the Knight Conference Center at the Newseum in Washington, DC. bringing together hundreds of health care and public policy professionals, including government regulators, thought leaders and Congressional staff.