HHS says it has launched an 18-month pilot project in five states to test a new method of measuring the quality of care HMOs provide to Medicare beneficiaries.
Performance indicators developed under a contract with the Delmarva Foundation for Medical Care will be tested at 23 managed-care organizations working with Medicare peer review organizations in California, Florida, Minnesota, New York and Pennsylvania.
The PROs will shift from their usual role of reviewing quality of care provided to Medicare beneficiaries to collecting data that will be used to measure the performance of managed-care plans.
The project will test the method of measuring quality of care before possible nationwide implementation.
"The rapid expansion of managed care adds urgency to the need to establish a reliable system for tracking the quality of care provided by plans," HHS Secretary Donna Shalala said.
Nationwide HMO enrollment, now totaling about 50 million, is increasing by 11% a year. About 2.3 million Medicare beneficiaries were enrolled in HMOs on Jan. 1, 1995-26% more than a year ago.
The pilot project will begin collecting data in July, including frequency of services provided in the 18-month period and access to preventive services such as mammography and flu immunization. The project also will focus on care provided to enrollees with diabetes.