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Assessing Quality in Managed Care: Health Plan reporting of HEDIS Performance Measures

Although the voluntary reporting system currently in place to assess and compare the quality of care provided by health plans continues to improve, it is still limited in the role it plays in providing information to purchasers and consumers.

Quality Compass, a collaborative effort between private and public purchasers and the managed care industry directed by the National Committee for Quality Assurance (NCQA), has succeeded in laying the foundation for a national quality report- ing system based on performance data obtained from the Health Plan Employer Data and Information Set (HEDIS) and the Member Satisfaction Survey (MSS).

However, with just one-third of all health plans choosing to report on HEDIS measures to Quality Compass, policymakers may need to evaluate other approaches to improving participation, including encouraging purchasers to require reporting of HEDIS data to NCQA.

The following analysis examines health plan reporting patterns for HEDIS measures to identify which factors contribute to plan participation in Quality Compass and how the present system could be improved.

 

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Assessing Quality in Managed Care: Health Plan reporting of HEDIS Performance Measures, The Commonwealth Fund, September 1998