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NCQA amends disease management standards

December 15, 2009 | Chelsey Ledue, Contributing Editor

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WASHINGTON – The National Committee for Quality Assurance has made changes to its disease management accreditation and certification requirements, adding voluntary performance reporting for five chronic conditions.

Employers, health plans and medical groups have developed disease management programs to alleviate the effects of chronic conditions and slow disease progression and reduce healthcare costs. NCQA’s accreditation and certification standards help purchasers select the most effective programs.

Changes to standards that assess the structure and processes of disease management programs focus on care coordination, data integration, quality improvement and transparency in reporting. One new standard requires organizations to report information on cost or efficiency measures to clients, including detailed information on how the results were calculated.

“These new standards will help employers hone in on disease management programs that best support their employees’ health. That means lower healthcare costs and higher productivity,” said Jeanette May, vice president of research and quality for DMAA: The Care Continuum Alliance. “It also means better quality of life and the ability for plan participants to take control of their long-term health.”

With the changes, NCQA officials say the organization becomes the first disease management accreditation organization to use performance measures to assess the impact of programs on care for people with asthma, diabetes, chronic obstructive pulmonary disease, heart failure and ischemic vascular disease.

“Disease management organizations provide vital support to the millions of Americans affected by chronic illnesses and those who treat them,” said NCQA President Margaret E. O’Kane. “Patients, purchasers and providers need to know the value that is being added and these new performance measures will allow that to happen.”

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