My mother was pretty sharp. Whenever my brother or I tried to skulk into the house with something tucked under our shirts, she'd always spot us and ask, "What are you hiding?"
Out would come the captured toad or the stray dog, and we'd be busted.
Since 1996, when its first HMO report card was issued, the National Committee for Quality Assurance has played the role of the sharp-eyed mom of managed care.
Today, the busted kids are the 20% of health plans that submit quality and patient satisfaction data to NCQA but choose not to allow its disclosure.
Correspondent Linda Boone Hunt, writer of this month's cover story, looks at managed care and its impact on patient quality and satisfaction.
What she finds is progress.
The NCQA demonstrates quality is improving at HMOs in many of the areas it has measured.
The top-ranked plans are getting better; so, too, are the lower ones.
And the smart plans are aligning physician incentives with quality improvement because they believe quality reduces costs.
But some plans just don't get it. They're trying to skulk into the house hiding subpar performance under their shirts. They are the 20% that won't disclose.
In aggregate, for each of 50 quality measures tabulated by NCQA and listed in its 2001 State of Managed Care Quality Report (available at www.ncqa.org), plans that didn't publicly disclose their numbers scored lower than those that did disclose. Their scores were poorer for clinical and patient satisfaction standards. The numbers show that the plans that hid themselves really did have something to hide.
The healthcare marketplace, finally, is becoming more transparent, thanks in no small part to NCQA. Transparency will be a powerful force driving quality improvement. Employers are demanding proof of quality care for their workers.
And as more companies shift to defined contribution healthcare coverage, employees will want to see the proof, too.
Patients will assume an even larger role as the sharp-eyed parents of their own healthcare purchasing decisions.
In this data-driven healthcare marketplace, the smart money will be on plans that are willing to stand up and be measured in public.