Assuring Fair Doctor Ratings: Nonprofit Approved to Independently Review Health Plan Programs That Assess Doctors.

WASHINGTON -- A national group of employer, consumer and labor organizations today named the nonprofit National Committee for Quality Assurance (NCQA), a leading health care quality organization, as an independent reviewer to certify that health insurers assess and report on the quality of physicians in an effective and fair manner.

The Consumer-Purchaser Disclosure Project, a group of employers, consumer groups and unions, is a major initiative which aims to improve health care and lower costs by holding health care providers publicly accountable for their quality of treatment. In April 2008, the Disclosure Project launched the Patient Charter--which detailed strict terms that health plans and other sponsors of physician reporting programs must meet.

With the Disclosure Project's endorsement, NCQA is the first approved independent reviewer that can ensure that health plans follow the guidelines of the Patient Charter.

"We need a transparent system, which gives everyone access to information they know is valid and fair in order to make major improvements in our health care system," said Debra L. Ness, president of the National Partnership for Women & Families and co-chair of the Consumer-Purchaser Disclosure Project. "The approval of an independent reviewer will help drive significant transformation in the performance of health plans and physicians, and it will improve the quality of information consumers have to make decisions about their care."

NCQA can now begin holding insurance companies and others that measure doctors, accountable to the terms of the Patient Charter, including the following:

* Assure that doctors are rated in a way that is meaningful to patients and reflective of an array of clinical activities

* Provide ways for physicians to be actively involved in the rating process; and give prior notice before releasing the information publicly

* Ensure that all measures and processes used are completely transparent - that there are no "black boxes"

* Promote measures that are based on national standards

With today's announcement, health plans and other sponsors of physician measurement programs can now begin examining their ratings processes with a clear idea of what NCQA will require and how to comply.

"Consumers, employers and policymakers have taken a keen interest in consistent measurement and reporting on the quality of physician care," said Peggy O'Kane, president of the National Committee for Quality Assurance. "The benefits of consistency are readily apparent to anyone who has looked for performance data when choosing a doctor. This is a big step forward."

The Disclosure Project will monitor and publicly report on the status of health plans and other groups that have committed to abide by the principals of the Patient Charter.

The Patient Charter (http://healthcaredisclosure.org/activities/charter) creates a set of uniform standards for assessing and reporting on physician performance that has garnered the support of both doctors and health plans. A core element of the Patient Charter calls for an independent reviewer to assess physician measurement and reporting programs against the Patient Charter's principles and make the results of that assessment public.

"Doctors and hospitals for the first time will be able to go to the Disclosure Project's Web site and see who is complying with the Patient Charter. Both doctors and patients will have new assurance that these measurement programs are based on fair and valid standards," said Peter V. Lee, executive director for national health policy of the Pacific Business Group on Health and co-chair of the Consumer-Purchaser Disclosure Project.

The Consumer-Purchaser Disclosure Project is an initiative that is improving health care quality and affordability by advancing public reporting of provider performance information so it can be used for improvement, consumer choice, and as part of payment reform. The Project is a collaboration of leading national and local employer, consumer, and labor organizations whose shared vision is for Americans to be able to select hospitals, physicians, and treatments based on nationally standardized measures for clinical quality, consumer experience, equity, and efficiency. The Project is funded by the Robert Wood Johnson Foundation along with support from participating organizations. For more information visit our Web site at http://healthcaredisclosure.org.