Coalition for Affordable Quality Healthcare Applauds I.O.M. Focus On Quality, Technology; 24 Health Plans' Collaborative Efforts Complement, Support Key IOM Recommendations.

Business Editors/Health & Medical Writers

ALEXANDRIA, Va.--(BUSINESS WIRE)--March 2, 2001

Members of the Coalition for Affordable Quality Healthcare (CAQH) applauded the Institute of Medicine report "Crossing the Quality Chasm," which was released yesterday.

The IOM report highlighted the need for continuing quality improvements and CAQH is working in several areas where the IOM suggests solutions can be found, including "making the most of technology" and encouraging closer collaboration between and among providers, health plans, and others in the health care system.

CAQH, a coalition of 24 of the nation's largest health plans covering more than 100 million Americans, is working together to improve the health care experience.

Over the past year, CAQH has identified and begun working on ways the health plan community can develop new technology systems and help doctors improve quality by sharing data and working collaboratively with one another and with health care providers. More information can be found at www.caqh.org.

"CAQH shares the IOM's goal of expanding access to quality affordable health care," said Leonard D. Schaeffer, Chairman of CAQH and also chairman and CEO of WellPoint Health Networks. "This report is a clarion that everyone in the health care community must continue and even ramp up efforts to improve quality, access, and affordability. We're joining together to do just that and welcome the active participation of more plans, providers, and purchasers."

"Like the Institute of Medicine, CAQH recognizes that efforts to improve health care require long-term commitment," said William T. McCallum, President and CEO of Great-West Life and Annuity Insurance Company and a CAQH board member. "We look forward to continuing to work with the IOM, physicians, and others in the health care community to jointly bridge 'the quality chasm' to ensure quality affordable healthcare."

In February, CAQH announced an update on progress it is making in three key areas: access to quality coverage, administrative simplification, and working with doctors to help them improve quality. Key CAQH initiatives that help solve problems identified in the IOM report include:

Sharing Knowledge about Quality Health Programs for Chronic Conditions: The IOM report notes the importance of focusing on ways many health care entities can work together to improve outcomes for patients with chronic conditions. In its work, CAQH is identifying and sharing quality health programs operating nationwide that seek to improve wellness and health outcomes.

To date, the CAQH knowledge sharing effort has identified 80 programs under way, including those that focus on asthma, diabetes, and other chronic diseases highlighted by yesterday's report.

Combining Technology Solutions with Quality By Creating Common Credentialing Across Plans: The IOM report stresses that health care organizations can play a powerful role in developing "a technology-based information infrastructure."

CAQH has started efforts to streamline paperwork and increase the time providers have to focus on patient care while also protecting patients by ensuring physician quality and education. Specifically, CAQH is developing a common form for "credentialing" - the process by which health plans assure physicians' credentials and education are up-to-date.

The impact for doctors is powerful - they will be able to fill out one form for all CAQH plans, instead of one for each of as many as 20 health plans with which they contract.

Working Together to Improve Quality, Reduce Errors through Correct Antibiotic Use: Antibiotics are one of America's most powerful weapons in keeping Americans healthy. But the health care community has increasingly recognized that misuse is reducing their effectiveness and causing a public health threat.

CAQH has partnered with the U.S. Centers for Disease Control and Prevention to begin education efforts for consumers and doctors and will be launching "local laboratory" programs in three U.S. regions to identify misuse patterns and share them with physicians to improve quality and reduce errors - one effort the report urged yesterday.

Using Technology to Streamline Pharmaceutical Information for Doctors: Pharmaceuticals are revolutionizing health care for many conditions and are driving tremendous innovation in health care. But with growing pharmaceutical options, physicians struggle to know which drugs are covered by insurance - adding administrative time for physicians.

CAQH has begun to build a database that will allow physicians to access all CAQH plan formularies in a consistent, easier-to-access way.

"As a physician, I know it is essential that we work together with those who provide care - America's doctors," said John W. Rowe, M.D., president and chief executive officer of Aetna Inc., which is a CAQH member. "Reducing the very real risk of antibiotic resistance or developing technology solutions to reduce paperwork are powerful examples of progress we can make together to improve quality as well as the health care experience for doctors and consumers."

The I.O.M report was issued yesterday by the National Academy of Sciences in Washington, D.C. Information about the report can be found at the National Academy of Sciences Web site, http://www4.nas.edu.

Health plans and insurers participating in CAQH are: Aetna Inc.; American Association of Health Plans; Anthem Blue Cross and Blue Shield; AultCare; Beech Street Corporation; CareFirst, Inc.; Cigna Corporation; Empire Blue Cross Blue Shield; FirstHealth; Great-West Life & Annuity Insurance Company; Group Health Cooperative of Puget Sound; Health Insurance Association of America; Health Net, Inc.; HealthPartners; Highmark Blue Cross and Blue Shield; Horizon Blue Cross Blue Shield of New Jersey; Humana Inc.; MultiPlan, Inc.; Mutual of Omaha; Oxford Health Plans; PacifiCare Health Systems Inc.; Private Healthcare Systems, Inc.; RightCHOICE Managed Care, Inc.; The Regence Group; Trigon Healthcare, Inc.; and WellPoint Health Networks Inc.