HCFA is working to develop a quality measurement tool for managed-care plans participating in Medicare and Medicaid based on the Health Plan Employer Data and Information Set used by private industry.
HCFA Administrator Bruce Vladeck disclosed the projects last week.
The projects come as the federal government, spurred by a desire to reduce the rate of growth in federal health programs, is considering ways to increase the penetration of managed care in the Medicare and Medicaid programs.
HCFA is working with the National Committee for Quality Assurance, which developed HEDIS, state Medi-caid directors, managed-care groups and others to develop a version of HEDIS for Medicaid managed-care plans, Vladeck told the Ways and Means Committee health subcommittee.
The object is to produce a Medicaid-specific performance measurement set by the end of 1995 and to get other Medicaid-relevant measures into the next version of HEDIS, which is under development (See related story, p. 20).
The Medicare project is "still on the drawing boards," according to Vladeck.
Currently, HEDIS specifically excludes managed-care enrollees who are 65 or older. However, according to NCQA President Margaret O'Kane, by the end of 1995, NCQA will have accredited over half the nation's HMOs, including plans that cover 66% of the Medicare beneficiaries enrolled in managed-care plans. Currently, slightly less than 10% of all Medicare beneficiaries are in managed-care plans.