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Related Experiment Video

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NCQA behavioral health measurement efforts.

Sarah Hudson Scholle1

  • 1National Committee for Quality Assurance, 2000 L Street, NW, Suite 500, Washington, DC 20036, USA. scholle@ncqa.com

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|April 5, 2005
PubMed
Summary

The National Committee for Quality Assurance (NCQA) sets quality standards for managed care using Health Plan Employer Data and Information Set (HEDIS) measures. Strategies are needed to improve depression care performance rates.

Area of Science:

  • Healthcare Quality Improvement
  • Managed Care
  • Health Services Research

Background:

  • The National Committee for Quality Assurance (NCQA) plays a crucial role in overseeing healthcare quality within managed care settings.
  • Health Plan Employer Data and Information Set (HEDIS) measures are key performance indicators used to evaluate managed care organizations.
  • Depression management is a critical area within managed behavioral health services.

Purpose of the Study:

  • To examine the NCQA's function in ensuring quality of care in managed care.
  • To identify innovative strategies for enhancing HEDIS performance rates, specifically for depression care.

Main Methods:

  • Review of NCQA's role and HEDIS measures.
  • Analysis of current performance in depression care management.

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  • Exploration of potential improvement strategies.

    • Main Results:

    • NCQA's HEDIS measures define the standards for managed care performance evaluation.
    • The depression medication management measure assesses treatment adherence and practitioner engagement.
    • Despite progress, HEDIS performance rates for depression indicate a need for further improvement.

    Conclusions:

    • NCQA's regulation of HEDIS measures establishes benchmarks for managed care quality.
    • Enhanced collaboration between managed care and managed behavioral health organizations is encouraged.
    • Incentive programs and pay-for-performance models are being explored to boost HEDIS performance in depression care.