16.06.2008 12:30:00
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UnitedHealthcare Achieves NCQA Physician and Hospital Quality Distinction
UnitedHealthcare, a UnitedHealth Group (NYSE:UNH) company, is one of the
first national health plans to achieve the Quality Plus Distinction for
Physician and Hospital Quality (PHQ) from the National Committee for
Quality Assurance (NCQA).
Quality Plus is a voluntary program for all NCQA-accredited
organizations that evaluates how well a commercial health plan complies
with standards in three categories: Member Connections; Care Management
and Health Improvement; and Physician and Hospital Quality. With PHQ
achievement, UnitedHealthcare now holds all three NCQA Quality Plus
distinctions in markets that service more than 17 million customers.
According to NCQA, PHQ standards are focused on four areas:
Standardization: NCQA supports standardized measures of
physician and hospital quality; where it is not possible, it
encourages the drive toward standardization. Quality and resource use
measures must be evidence-based, reliable and valid.
Transparency: These standards require that specifications
measuring physician and hospital performance be available to the
organizations being measured and the public.
Collaboration: These standards encourage collaboration among
plans by streamlining the review process for organizations
participating in collaborative measurement initiatives. The standards
also support collaboration between plans and providers –
a key to successful measurement activities.
Action: The objective of measurement is quality improvement and
affordability. Health plans should take specific actions to improve
performance, such as reporting and engaging in quality improvement
activities or using payment and product design strategies.
"By meeting NCQA Physician and Hospital
Quality standards, UnitedHealthcare has demonstrated it provides its
health plan participants with important information about physicians and
hospitals within its network, thus enabling consumers to make better
health care decisions for themselves and their families,”
said NCQA President Margaret E. O’Kane.
Sam Ho, M.D., UnitedHealthcare’s executive
vice president and chief medical officer, said: "At
UnitedHealthcare, we believe that by partnering with physicians we can
develop health care information programs - using standardized,
evidence-based care and claims data - that enable consumers and our
employer customers to make better, more informed decisions. We welcome
independent review of our programs, which helps us ensure our customers
have access to meaningful information they can use to help them lead
healthier lives.”
NCQA’s Distinction standards are intended to
help organizations like UnitedHealthcare achieve the highest level of
performance possible by measuring programs to improve health outcomes,
patient connectivity and disclosure of provider performance as well as
create an environment of continuous improvement.
The UnitedHealth Premium physician designation program, which builds on
UnitedHealthcare’s 10-plus years of assessing
physician and hospital performance, analyzes physician practices based
on established and accepted clinical guidelines for quality care.
Available online at www.uhc.com, the
UnitedHealth Premium physician designation program enables
UnitedHealthcare customers to compare quality and cost-efficiency
information for physicians and facilities within their communities. The
program gives more than 17 million UnitedHealthcare plan participants
access to this information.
The PHQ distinction was previously earned by PacifiCare of California, a
UnitedHealthcare company. The NCQA distinction for that plan was based
on UnitedHealthcare Quality Index Profiles for Medical Groups and
Hospitals, which include quality, cost and efficiency measures that
consumers can use to select medical groups. The results are incorporated
into the Quality Incentive Program for delegated medical groups.
About NCQA
NCQA is an independent, not-for-profit organization dedicated to
measuring the quality of America’s health
care. Consumers can access an organization’s
NCQA Distinction status and other information on health care quality at www.ncqa.org/reportcards.aspx.
About UnitedHealthcare
UnitedHealthcare (www.unitedhealthcare.com)
provides a full spectrum of consumer-oriented health benefit plans and
services. The company organizes access to quality, affordable health
care services on behalf of more than 25 million individual consumers,
contracting directly with more than 560,000 physicians and care
professionals and 4,800 hospitals nationwide to offer them broad,
convenient access to services nationwide. UnitedHealthcare is one of the
businesses of UnitedHealth Group (NYSE:UNH), a diversified Fortune 50
health and well-being company.
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