Managed Care

 

Second 'Quality Plus' Standards Released

MANAGED CARE August 2005. © MediMedia USA
News and Commentary

Second 'Quality Plus' Standards Released

MANAGED CARE August 2005. ©MediMedia USA

Nearly 60 health plans have signed on as "early adopters" of the care management and health improvement standards newly updated by the National Committee for Quality Assurance. They are part of NCQA's Quality Plus Program, which allows NCQA-accredited plans to pursue additional distinction in selected areas by meeting tough new standards even before they become mandatory.

"In five years, most health plans will engage in the kinds of activities that we're looking for with these new standards," says NCQA President Margaret E. O'Kane. "But if you're selecting a health plan tomorrow, you really want to know which plans are taking steps now to prevent and manage chronic condtions.

Health plans that excel at engaging members in wellness and prevention programs will do well. These plans might identify and recruit smokers into smoking-cessation programs or send out reminders to members who missed routine screenings.

The new standards also look at how well an organization uses resources to identify and manage patients with chronic illnesses or complex conditions. The standards ask not only whether these "case management" programs exist, but also how effectively members who might benefit are referred to the programs.

Meetings

4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015