Question

Managed care organization credentialing by the National Committee on Quality Assurance rapidly evolved as a standard of quality in the industry. Based on your knowledge of the process, discuss your views on the value of credentialing by an independent organization to a managed care organization and to consumers.

Answer 1

The National Committee for Quality Assurance is a private, nonprofit organization dedicated to improving health care quality. It was found in 1990, and since then NCQA has played a pivotal role in improving the health care system. The NCQA seal is a widely recognized symbol of quality. Organization incorporating the 'National Committee for Quality Assurance' seal into advertising and marketing materials must first pass a rigorous, comprehensive review and must annually report on their performance.

For consumers and employers, the seal of National Committee for Quality Assurance (NCQA) is a reliable indicator that an organization is well managed and delivers high-quality care and service. It has helped to build around important health care quality issues by working with large employers, doctors, patients, policymakers and health plans to decide what is important, how to measure it, and how to promote the improvement of the health care quality standards.

The contribution of National Committee for Quality Assurance (NCQA):

• The statistics that track the quality of care delivered under National Health Care Plans, have improved immensely.
• The healthcare protocols have been refined- Doctors have learned new ways to practice, patients have become more engaged in their care.
• Accredited health plans face a rigorous set of 60 standards and must report their performance in more than 40 areas in order to earn the seal of approval of the National Committee for Quality Assurance.

These standards will promote the adoption of strategies that will improve care and enhance service to the consumers, such as paying providers based on their performance, leveraging the web to give more information, effective disease management, and physician- level measurements to the consumers. Thus improvement in quality care will translate into lives saved, illness avoided, and costs reduced.