The article "NCQA draft is boost for docs" (May 12, p. 19) may have been a bit too optimistic for physicians.
According to a May 7 press release, the program is designed to "help streamline the (National Committee for Quality Assurance's) accreditation process for managed-care organizations by substituting a single NCQA survey of each participating physician organization for the overlapping annual reviews they currently face from managed-care organizations seeking NCQA accreditation."
In other words, the program's purpose is to review physician organizations to determine if certain functions meet the NCQA's standards so managed-care firms can be assured their accreditation status isn't at risk if they enter contractual arrangements with the physician group.
With increased opportunities for physician organizations to contract directly with purchasers and compete with managed-care plans, it would be beneficial for the consumer if the NCQA's physician organization certification program would evaluate physician groups as stand-alone entities rather than extensions of managed-care plans.
By expanding the mission and scope of the certification program, an accredited physician organization would be able to demonstrate its efficiencies and benefits to the consumer in the terms and measurements consumers are rapidly learning to understand. Also, by being in compliance with the NCQA's standards, a physician organization can determine its contribution and value within a managed-care plan and as a stand-alone entity.
For the NCQA plan to be a real "boost" for physician organizations, they must be recognized as business organizations that have the potential to contract directly with employers, not just be part of managed-care plans' provider networks.
Sally J. Sjobeck
Sidus LLC, Nashville