NCQA in the News – on the Affordable Care Act and HEDIS

August 2, 2017 · NCQA Communications


NCQA in the News

In the news this week lies the question, what will happen to the Affordable Care Act marketplaces if cost sharing reduction (CSR) subsidies are eliminated?  CSRs are federal government payments to insurance companies to help reduce copays and deductibles for lower income Americans.

The Trump administration has been making the CSR payments on a month to month basis and is considering ending them altogether.

NCQA Weighs in…

CNBC correspondent, Bertha Coombs asked NCQA President Peggy O’Kane to weigh in. “We are at a point of tremendous urgency to get this resolved,” said Peggy, with insurers facing deadlines to file their final rate requests over the next two weeks.

Given the uncertainty, researchers and experts predict many insurers will likely exit the marketplaces.  “It’s unclear to me if decisions have been made at the administration level about this because of hurt feelings” following last week’s vote, said Peggy to CNBC.

Read the complete CNBC article here.

NCQA in the News

In other news, Anna Gorman with Kaiser Health News reached out to NCQA for comment on a recent report by the Centers for Disease Control and Prevention (CDC) on blood pressure control among low-income patients. The report shows success in controlling blood pressure based on results from NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS) measures.  HEDIS measures were used to compare Medi-Cal Managed Care Plans from 2014 to 2015, which shows a five percent increase in patients who stabilized their blood pressure.

NCQA’s Mary Barton said just measuring a health outcome like hypertension control and sharing the data can have an impact.

Indeed that seems to be the case, as the article points out – while five percent may not seem like a huge increase, overtime that could mean fewer heart attacks and strokes.

For more on the report, read the California Healthline article here.

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