NCQA: Accreditation Planned for Physician Groups
The National Committee for Quality Assurance has announced plans to launch an accreditation program in California for physician group practices and independent practice associations that may ultimately complement current accreditation processes for individual physicians and health plans, American Medical News reports. The program is intended to address an increase in the demand across the health care market for comparative quality data on physicians, as reflected by growth in the number of insurer-sponsored medical group ratings. Currently, NCQA and a handful of other organizations offer little-used certification programs for responsibilities that health plans are increasingly designating to physician groups, such as utilization management. Ideally, NCQA's proposed program would supersede the current physician group evaluation process, in which organizations undergo costly reviews and site visits by multiple health plans. Physicians and insurers feel the key to the proposal's success "is whether the voluntary program ultimately streamlines oversight of doctor groups or just proves to be one more burdensome review," concurring that a comprehensive accreditation program "could prove useful and popular ... [i]f designed to dovetail with plan accreditation standards." One profiled California physician organization, Beaver Medical Group, which represents 130 physicians, spends more than $300,000 per year to meet the review requirements of 20 health plans. As these costly reviews fail to provide adequate quality benchmarking data, the group also invests $30,000 to achieve three-year accreditation by the California Medical Association's Institute for Medical Quality, despite group leaders' view of the evaluation as limited in its usefulness. A comprehensive accreditation seal that would eliminate redundancy and offer quality benchmarking "would be very attractive," observed Dr. Ronald Bangasser, medical director of Beaver Medical Group.
But Will Doctors Buy In?
Details of the program have not been finalized, but officials said it will be "performance-based" and may be expanded nationwide in 2000. For other industry groups, namely hospitals and health plans, accreditation is "virtually a condition of doing business." However, the extent to which physician organizations will echo that sentiment is unclear. Bangasser predicts the initiative could catch on in New York, Massachusetts and Florida, but may struggle to "take off" in other states. Dr. Antonio Legorreta, director of the quality data division of Health Net's parent company, said, "If accreditation is just going to document and improve quality, that's an altruistic goal, but it doesn't make economic sense from [the physician groups'] perspective. ... There will have to be a combination (of economic and quality improvements) before medical groups will invest in these efforts" (Prager, 8/23).