Thursday, November 8, 2007

Sometimes It's the Little Things--The NCQA Announces an Agreement Between Providers and Payers to Better Pay for the Quality of Care

Particularly in this election season we tend to focus on the big health care reform plans. It is natural to want to see a big fix to a big problem. But everyday things are going on in the market that can make a difference. Make no mistake, these good works will not replace the need for systemic health care reform but it would be wrong to think just big policy changes are the only answer.

A case in point is the news that the National Committee for Quality Assurance has scored a big breakthrough in yesterday's New York Times.

The new model would help employers and insurers to spot the best docs and then attempt to encourage employers and insurers to use them. The doctors would be better compensated for doing more than is now the case for things like office visits.

The objective is to give doctors incentives to spend more time with patients during office visits and in other contacts such as phone calls and emails.

Doctors would also be paid for being more proactive in helping patients manage chronic conditions. Apparently associations representing more than 300,000 primary care doctors have accepted at least "some of the measures." A number of insurers are also on board including Wellpoint, United, Humana, CIGNA, the Blue Cross Association and a number of pharmacy benefit managers (PBMs) and employers.

This is a small step (relative to major health care reform) that is a huge accomplishment by the NCQA in making the system more efficient and effective and would be important no matter what the outcome of political health care reform.

Good for the NCQA and the providers and payers that have come to the table.


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