HEALTHNET: HMO’s Lack of Accreditation Spurs Employer ‘Freeze’
HealthNet's decision to "op[t] out" of the National Committee for Quality Assurance accreditation process this year has led several large employers to "freeze" their worker's membership in the HMO, the Los Angeles Times reports. Chevron Corp., Safeway Inc., Stanford University and APL Ltd. will suspend their employees' membership in HealthNet. The Pacific Business Group on Health and the California Public Employees' Retirement System plans to monitor HealthNet's quality of care until the HMO is reaccredited. According to HealthNet Medical Director Jennifer Gutzmore, the HMO chose not to apply for accreditation this year because the necessary documentation for application had not been "properly maintained" during a management change in 1999. (Bernstein, Los Angeles Times, 10/26). "We consider this a serious issue. ... Our goal is to provide high quality, cost-effective health care for our employees, retirees and their families, and accreditation is one of the main standards we use to evaluate health plans," Bruce Smith, Chevron's health care team leader, said. PBGH President and CEO Peter Lee said, "Large purchasers are strongly committed to NCQA accreditation as one tool for assuring quality. It provides a rigorous review of a health plan's processes and outcomes, including an onsite review and more than 60 different standards to evaluate the health plan's clinical and administrative systems" (PBGH release, 10/26). CalPERS has sent letters to its 235,000 HealthNet-enrolled members noting HealthNet's current lack of accreditation. CalPERS health benefits executive Allen Feezor said the organization is "concerned" and is "working to affirm that HealthNet's quality of care is maintained while they're seeking to regain accreditation." Expressing "surprise" at the employer response, Gutzmore said that quality of care would not be compromised. HealthNet plans to apply for accreditation again next year, Gutzmore said (Los Angeles Times, 10/26).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.