The National Committee for Quality Assurance, Essay Example

The National Committee for Quality Assurance (NCQA) is a 501(c)(3) non profit and private organization, whose vision is to improve health care in America.  The NCQA originally began in 1979, though lack of funding in the 1980’s made it difficult for the organization to succeed (McPartland).  McPartland reports that other systems were in place and deemed to be effective in monitoring health care.  However, by the end of the 1980’s, the health care system clearly required stronger controls (McPartland).  In 1990, the NCQA re-emerged and became a powerful force in promoting the high-quality service in all levels of health care.  According to the NCQA website, the NCQA’s main objective is to increase the quality of health care through better measurement of procedures and outcomes, transparency of services, and accountability for services.  The mission of the NCQA is to establish quality standards and performance measures for health care providers and services.  The NCQA’s formula for improving health care is to measure health care standards and results, analyze those results, improve what is lacking, and finally to repeat the measures that were successful.  The results of health care organizations are measured and analyzed to see where improvements can be made.  The NCQA works with employers, physicians, patients, health plans, and public health officials to determine the areas in which improvement is needed.

Because it is a national standard of quality, the majority of health care organizations aim to be accredited with the NCQA.  To be accredited, health plans must observe more than sixty standards and must report on their performance in more than forty areas.  Health care organizations must then adopt strategies to improve health care, enhance service, and reduce costs.  The NQCA website lists examples of hurdles to accreditation as paying providers based on performance and providing consumers with more information regarding health care with the Internet.

The HMO Employer Data and Information Set (HEDIS) is an informational tool used by the NCQA to measure inpatient and outpatient care and service in the majority of America’s health plans.  McPartland and the NCQA website list examples of where the HEDIS is used to improve health car to be smoking cessation, managing antidepressant medications, pediatric access to primary care physicians and immunizations, prenatal and post-partum care, breast and cervical cancer screenings, management of hypertension, and comprehensive diabetes care.  Health plans use the information on the HEDIS to see where they need to improve their services.  According to the NCQA website, all data are audited by certified auditors using a process designed by the NCQA to make certain that the HEDIS results are valid.  To ensure that information in the HEDIS is up-to-date, the NCQA has established the NCQA’s Committee on Performance Measurement.  This group represents employers, consumers, and health plans, and evaluates the information provided by HEDIS.  According to the NCQA website, the NCQA’s Committee on Performance Measurement determines what HEDIS measures are included and the exact field tests to determine the process of analysis.  The HEDIS provides consumers the information required to compare the performance of health care plans in the “Quality Compass.”  This Internet tool provides an interactive program that allows users to view plan results and standard information.  Consumers are also able to take surveys to evaluate and provide information regarding their care, billing procedures, and customer service experience.  The HEDIS is one more method the NCQA uses to promote quality health care in America.

Works Cited

“About NCQA.” 25 Years of Quality NCQA. NCQA. Web. 27 Apr. 2015. < http://www.ncqa.org/AboutNCQA.aspx>

“HEDIS® and Quality Compass®.” 25 Years of Quality NCQA. NCQA. Web. 27 Apr. 2015. <http://www.ncqa.org/HEDISQualityMeasurement/WhatisHEDIS.aspx>.

McPartland, Ginny. “Birth of the National Committee for Quality Assurance.” A History of Total Health. Kaiser Permanente, 21 Mar. 2012. Web. 27 Apr. 2015. <https://kaiserpermanentehistory.org/latest/birth-of-the-national-committee-for-quality-assurance/>.