• By the year 2002, earned benefit program customers will (a) be paid the right amount on the day payment is due, and (b) receive responses to their inquiries and service requests that are accurate and that meet or exceed their expectations.

RIS strengthened its leadership role in the health insurance industry by building and maintaining strong relationships with the National Commission for Quality Assurance (NCQA), the Health Care Finance Administration (HCFA) , the Department of Health and Human Services, and the Foundation for Accountability (FAACT). These partnerships have been instrumental in promoting the use of health care quality outcome measures by OPM and health care purchasers and providers throughout the nation, led to the adoption of the Consumer Assessment of Health Plans Survey (CAHPS) customer survey instrument as an industry standard, and resulted in modifications to NCQA’s Accreditation 99 process that will better meet the needs of the FEHB Program.

During the early and mid-1990s, RIS firmly established the concept of performance standards with the carriers participating the FEHB Program and these standards are now a part of the carriers’ contracts with OPM. Because of the dynamic nature of the health care industry, RIS is taking a conservative approach in establishing expected levels of performance from the carriers.

HEALTH BENEFITS PROGRAM - PERFORMANCE INDICATORS