URAC (American Accreditation HealthCare Commission) Consumer Coalition for Quality Health Care National Committee for Quality Assurance
Contact: Liza Greenberg, URAC (202) 216-9010 x 8805
Brian W. Lindberg, Consumer Coalition (202) 789-3606
Brian Schilling, NCQA (202) 955-5104 Thursday, October 05, 2000News Release
URAC, CONSUMER COALITION FOR QUALITY HEALTH CARE, AND NCQA COLLABORATE ON FIRST-EVER CONFERENCE ON PPO QUALITY
Conference to Examine Approaches to Accountability for Fastest-Growing Segment of the Health Care System
WASHINGTONURAC, the Consumer Coalition for Quality Health Care, and the National Committee for Quality Assurance (NCQA) announced today that they are collaborating to present a first-ever conference to examine performance assessment tools for preferred provider organizations (PPOs). The conference will examine techniques that allow PPOs to report standardized quality information to consumers and purchasers and will define areas in need of future research on PPO quality. The two-day conference, PPO Performance Measurement: Agenda for the Future, part of a broad effort to address the largest and fastest-growing segment of Americas health care system, will be held on March 15-16, 2001 at Washingtons Four Points Sheraton Hotel. The conference is supported by a grant to URAC from the federal Agency for Healthcare Research and Quality.
According to Brian W. Lindberg, Executive Director of the Consumer Coalition, Consumers need to examine the advantages and disadvantages of PPO systems and work with PPOs to ensure meaningful accountability. Consumers also need better tools to assess whether they are receiving quality care from PPOs. This conference is an important first step in developing those tools. Prior to the national conference, the Consumer Coalition will produce a pre-meeting workshop for consumer organizations, which will help define consumer priorities for PPO performance measurement.
PPOs constitute the largest and fastest growing sector of the health care industryover 100 million Americans are enrolled in PPOsbut historically, little quality information about the nation's 1,000+ PPOs has been available.
The conference will examine the applicability of existing managed care organization performance measurement tools to PPOs, and will also identify innovative new strategies for assessing care in PPO systems. Key issues for the conference will be:
Developing a better understanding of the need for performance information from providers, regulators, purchasers and consumers, and the potential impact of performance requirements on PPO delivery systems; Understanding what data are available to PPOs and how that influences performance measurement; Understanding the applicability of standardized measurement tools to PPOs; Identifying innovative approaches used by PPOs to improve quality, including web and information based strategies to inform consumers about quality; Examining the potential for standardized measures of service quality such as complaint resolution and financial management; and Examining how PPOs contribute to preventive care delivery.
We expect an audience of consumer organizations, researchers, provider organizations, PPO quality staff and purchasersthose who have a need to know how well PPOs deliver care, said Liza Greenberg, Vice President of Research, URAC. These groups can and should take part in defining strategies for PPO accountability that lead to improved quality.
We have created this conference to bring stakeholders together, which is key to establishing a dialogue and affecting change, said Andrew Webber, Vice President, Public Policy, NCQA. With the help of all concerned, we will look to develop assessment tools that will allow PPOs to be measured and compared on equal terms.
URAC, NCQA, and the Consumer Coalition are also commissioning a series of papers by health services researchers to examine technical issues relating to PPO performance measurement and identify research needs for the future. A planning committee representing PPOs, consumers, researchers, employers, and federal agencies is developing the national conference agenda.
URAC is the nations largest accrediting body for PPOs. URAC accredits over 70 PPOs, including 35 PPOs who have undergone URACs health network accreditation program. URACs accreditation standards require PPOs to establish a program of quality management and improvement, and to address quality issues in provider contracts and monitoring. URAC also has published two books on the PPO industry, The PPO Guide and Rise to Prominence: The PPO Story. These two resources are the most comprehensive available on PPO regulation, operations, and quality measurement techniques. For more information, visit URACs Web site at www.urac.org.
The Consumer Coalition for Quality Health Care is a national non-profit membership organization of health care consumer organizations. Since its inception in 1993, the Consumer Coalition has worked on national policy development and advocacy on issues related to quality of care improvement, measurement and reporting. The organization seeks to give voice to the consumer perspective as the public and private sectors develop systems of quality accountability. The Consumer Coalition advocates for the principles of choice and consumer information, quality assurance, consumer protection and public accountability in health care. Members of the Coalition include national consumer advocacy groups and other organizations interested in promoting quality health care on behalf of consumers. Members include the American Association of Retired Persons, the Medicare Rights Center, The National Council on the Aging, Families USA, Citizen Advocacy Center and many others.
NCQA is a private, non-profit organization dedicated to improving health care quality. More than three-quarters of Americans enrolled in HMOs are in plans that have been reviewed by NCQA. The organization recently expanded its oversight programs to include accreditation and certification of PPOs. NCQA also manages the evolution of HEDIS, the performance measurement tool used by more than 90 percent of the nations health plans. NCQA is committed to providing health care quality information through the Web and the media in order to help consumers, employers and others make more informed health care choices.
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