Accountability Equalizes Managed Care Players: Firm Sets Program To Assist PPOs Gain Accreditation.

NEWTON, Mass.--(BUSINESS WIRE)--July 14, 1999--

For the past ten years, Scheur Management Group (SMG), a nationally known managed care consulting firm, has been assisting Managed Care Organizations (MCOs) and health care providers to meet financial, operational, accreditation, and regulatory mandates to which they have been increasingly subjected.

As part of this effort, SMG has successfully assisted many HMOs to comply with and meet the quality standards set forth by the National Committee for Quality Assurance (NCQA). Recognizing that quality standards are not always enough to assure the success of such organizations, SMG recently launched an operational and revenue enhancement program, MCORE, to add another dimension to assuring the viability of HMOs. Now, in response to the recent NCQA announcement regarding accreditation of Preferred Provider Organizations (PPOs), SMG has added a new pre-survey analysis and implementation plan to prepare PPOs in meeting the anticipated NCQA oversight accreditation process.

"Our goal is and has been to assist our clients, no matter what aspect of the managed care industry they serve, with implementing quality standards and operational management tools, which enable them to provide the best possible care to their consumers", notes SMG's President, Barry Scheur.

Scheur continues, "We believe in preventive medicine, and that encompasses evaluating and assessing health plans to identify problems and suggest realistic solutions that allow for the promotion of the best practices in managed care. No longer is it enough just to reduce costs or demonstrate cost effectiveness. Quality service is inherent in producing superior outcomes".

In response to this latest development in the managed care industry, SMG's Chief Medical Officer, Dr. Paul Reich, noted the firm's capability to immediately implement this new initiative to assist PPOs in successfully attaining accreditation. PPOs, noted for their less restrictive access to health care services with increased revenue streams due in part to increased higher consumer costs than the HMO side of managed care organizations, have heretofore not been subjected to either accountability or quality standard surveys. Dr. Reich confirms that the industry has been anticipating a monitoring system, which may also reach into indemnity plans to "level the field of health providers in assuring an equal standard in the provision of health care services and coverage". Reich continues, "By establishing criteria by which all such organizations can be monitored, NCQA is assuring that consumers can make informed decisions, based not just on cost and content of provided services, but also, perhaps most importantly, on the quality of services and response to customer service".

SOURCE: DigitalWork ( http://www.digitalwork.com )

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