NCQA Applauds Sen. Baucus' Proposal to Expand Medicare Pay-for-Quality Efforts; Current Payment Policies Often an Obstacle to Quality Care 6/23/2004
From: Barry Scholl or Brian Schilling, 202-955-5197 or 202-955-5104, both of the National Committee for Quality Assurance, Web site: http://www.ncqa.org WASHINGTON, June 23 -- The National Committee for Quality Assurance (NCQA) today praised the introduction of The Medicare Quality Improvement Act of 2004 by Sen. Max Baucus (D-Mont.) that would create financial incentives for Medicare health plans to improve the quality of care they provide to beneficiaries. Current payment policies fail to reward high performance and can paradoxically reward poor quality care. NCQA is among the leaders of a national movement toward pay-for-quality reforms. NCQA President Margaret E. O'Kane praised Senator Baucus' leadership and supported his belief that linking payment and quality will improve care and save money. "With pay-for-quality, what you're paying for is health," said O'Kane. "With traditional payment systems, you're really just paying for health care -- which may or may not be of good quality. Pay for quality is a smart, value-based approach to spending health care dollars that makes it clear that the market won't accept the status quo." Sen. Baucus' bill would create a National Performance Quality award program for the highest performing plans and a National Quality Improvement program that would make payments to all Medicare plans that show improvement in the quality of care provided to beneficiaries from one year to the next. Initially, these rewards would be based on a plan's performance on certain HEDIS(r) (Health Plan Employer Data and Information Set), CAHPS(r) and other performance measures. NCQA is responsible for the evolution of HEDIS, a tool used by most of the nation's health plans to monitor and report on their performance in areas such as immunization and mammography rates, blood pressure control, and diabetes care. CAHPS is a member satisfaction survey maintained by the federal Agency for Healthcare Research and Quality. NCQA participates in the employer-sponsored Bridges to Excellence program, which rewards physicians who demonstrate that they delivery quality care as defined by the American Diabetes Association/NCQA Physician Recognition Program. In California, NCQA was instrumental in developing a set of clinical performance measures used in the Integrated Healthcare Association's Pay-for- Performance (P4P) initiative. Health plans participating in P4P will provide incentive payments to their physician groups based on their performance on these measures. The first P4P awards, totaling tens of millions of dollars, are expected to go out within the next three months. 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 offers recognition programs for physicians and physician groups. 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. ------ "HEDIS" is a registered trademark of the National Committee for Quality Assurance; "CAHPS" is a registered trademark of the Agency for Healthcare Research and Quality. |