MANAGED CARE October 1998. ©1998 Stezzi Communications
Just a week before the National Committee for Quality Assurance released 1997 HEDIS data, a Commonwealth Fund study burst the buildup over the HEDIS release like a badly worn tire.According to the authors, only 6 percent of employers of 200 or more workers use HEDIS (Health Plan Employer Data and Information Set) information to select managed care plans. Only 9 percent require NCQA accreditation.
Not that the authors wrote off HEDIS and NCQA accreditation as irrelevant. Rather, they excoriated employers for demanding quality but then not rewarding plans that try to demonstrate a commitment to it — saying that the managed care backlash “may be directed at the wrong player.”
For their part, purchasing coalitions are doing all they can to spread the word this month, a time when many large companies are right in the middle of open enrollment. The Pacific Business Group on Health, for instance, is displaying its health plan, hospital and physician report cards on its web site, http://www.healthscope.org/
Meanwhile, PacifiCare is turning the quality question around. The HMO released a “quality index” that compared its largest medical groups in California on 12 measures of care and service. PacifiCare thinks the results will cause members to gravitate toward “blue ribbon” groups.
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Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.