Health plan accountability and reporting: issues and challenges

• Published in: Health affairs (Millwood, Va.) Vol. 17; no. 2; pp. 152 - 155
• Main Authors: Roper, W L, Cutler, C M
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 01.03.1998
• Subjects: Accountability; Accreditation; Automation; Consumer health information; Consumers; Costs; Data Collection; Employers; Federal employees; Group health insurance; Health care; Health care delivery; Health care industry; Health care policy; Health informatics; Humans; Information sharing; Managed Care Programs - standards; Measurement; Medicaid; Medical records; Medicare; Performance evaluation; Quality assurance; Quality control; Quality Indicators, Health Care; Quality of Health Care; Quality of service; Quality standards; Social Responsibility; Studies; United States; United States; United States > US
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.17.2.152

For a decade there has been a growing movement to hold health plans accountable to their clients and members through performance measurement systems. For accountability systems to work, they must include health plan and service measures that produce information that is valued by health care purchasers and consumers. The need of such measures led to the development of health plan accreditation by the National Committee for Quality Assurance and others, beginning in 1991. It also led to the NCQA's development of the Health Plan Employer Data and Information Set in 1993. Further work is needed on the technical issues of performance measures and on related matters such as the automated medical record and community health services.