New NCQA Web Site Details New York Health Plans Performance on Standards of Physician...

New NCQA Web Site Details New York Health Plans Performance on Standards of Physician Quality Measurement

Plans, New York Attorney General Agreed to Standards in November
WASHINGTON--(Business Wire)--
A new Web site launched by the National Committee for Quality
Assurance (NCQA) provides for the first time detail on the extent to
which health plans in New York measure and report on physician
performance in accordance with an agreement reached between the health
plans and New York Attorney General Andrew Cuomo. The plans were
assessed by NCQA--designated as a Ratings Examiner under the
agreement--using standards adapted from the organization's Physician
and Hospital Quality program.

In 2007, seven health plans that had implemented a physician
performance measurement program in New York reached agreement with the
Attorney General's office on a set of requirements for physician
measurement programs. The Web site, nyrxreport.ncqa.org, provides
details on the extent to which health plans comply with provisions of
the agreement. Such provisions include verification of the accuracy of
measurement methods, the involvement of physicians in the program's
development, and the right of physicians to request changes or
corrections to data.

"Few decisions a patient makes hold greater sway over their health
than their choice of a physician. Rating physicians fairly with
trusted, transparent measures of quality gives patients a meaningful
foundation for making these choices," said NCQA President Margaret E.
O'Kane. "Our Web site takes physician rankings out of the black box
and sheds light upon what goes into plans' physician measurement
efforts."

Plans with physician measurement, rating and tiering programs must
score 100 percent on reviews against the applicable requirements set
forth in the agreement. Not all requirements apply to all plans. Plans
that are not in full compliance with the requirements must take
corrective action and be reevaluated.

"New Yorkers deserve to know what goes in to a doctor's
'high-performance' designation from a health plan," said Attorney
General Cuomo. "Ratings examiners such as NCQA provide independent
verification that these rankings are arrived at equitably and are
based on sound science. This is a terrific step forward for
physicians, patients and health plans alike."

The first plans to have their results displayed on the site are
CIGNA HealthCare of New York, an HMO, and Connecticut General Life
Insurance Company, also a CIGNA company. "We're proud that CIGNA's
programs were the first to be reviewed under this national model for
physician evaluation programs, consistent with our agreement with the
New York Attorney General, and we're pleased with the results of that
review," said Dick Salmon, M.D., National Medical Director for CIGNA
HealthCare. "We want the individuals we serve to know that the
information we make available about the performance of physicians
is based on identified clinical measures and fairly applied. Our goal
is to provide people with information that they can use, along with
other data and advice from their current doctor, when choosing
a specialist."

Reviews for Aetna and United Healthcare are currently in process;
their results will be made available later this year.

Plans are reviewed on standards are adapted from NCQA's Physician
and Hospital Quality program. The standards, first released in 2006,
evaluate health plans' efforts to measure and report on physician and
hospital performance. NCQA released an updated version on the
certification--available to organizations nationwide--in June.

To view the performance of health plans against the standards,
visit http://nyrxreport.ncqa.org.

NCQA is a private, non-profit organization dedicated to improving
health care quality. NCQA accredits and certifies a wide range of
health care organizations and recognizes physicians in key clinical
areas. NCQA's Healthcare Effectiveness Data and Information Set
(HEDIS(R)) is the most widely used performance measurement tool in
health care. NCQA is committed to providing health care quality
information through the Web, media and data licensing agreements in
order to help consumers, employers and others make more informed
health care choices.

National Committee for Quality Assurance (NCQA)
Jeff Van Ness, 202-955-3518

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