Accreditation by the National Committee on Quality Assurance (NCQA): a description

The objective of this article is to describe the National Committee on Quality Assurance (NCQA). The NCQA is one of many organizations that is addressing the issues of quality assurance of health care for HMOs. It is of concern that when HMOs focus on cost they may stint on services. Also it is difficult for HMOs to compete for both quality and cost if there is not a comparable objective standard of measurement. The NCQA offers a level of accreditation that is representative of organizational structure and resources. The Health Plan Employer Data and Information Set (HEDIS) is used to compare outcomes and professional resources. The results of both the accreditation and the HEDIS measures are compiled in a national data base, The Quality Compass. There is skepticism that the NCQA is measuring the correct data for basing quality measurement decisions and also the data obtained is severely underutilized by health care purchasers (employers with less than 1,000 employees).