THE BUREAU OF NATIONAL AFFAIRS: HEALTH PLAN & PROVIDER REPORT - JULY 3, 2002
Accreditation Group, House Panel Chair Promote Disease Management for Industry
An accreditation group and a key House Republican June 26 promoted diease management as a way of helping patients handle chronic conditions such as diabetes and asthma.
Rep. Nancy Johnson (R-Conn.), who chairs the House Ways and Means Subcommittee on Health, praised a new disease management initiative of the National Committee for Quality Assurance. She has also introduced legislation in 2001 (H.R. 3584) that would promote disease management in the Medicare+Choice program.
"Recognizing effective disease management programs through accreditation will help ensure that chronically ill individuals get the best care possible," said Johnson. "I applaud NCQA in their efforts."
NCQA President Margaret O'Kane said, "If the health care system did everything right in terms of treating chronic illnesses, most chronically ill people could live long and productive lives." O'Kane added that promoting disease management is "about making the best practice the standard practice."
On June 10, Washington-based NCQA announced that American Healthways would be its first recipient of disease management accreditation. The primarily Web-based accreditation program tests how health care providers prepare for and respond to chronic illness. Other programs which are currently being evaluated by NCQA include AdvancePCS, Blue Care Network of Michigan, and GlaxoSmithKline HealthCare Management (8HPPR 723, 6/19/02).
In its June 26 statement, NCQA said accreditation for disease management has benefits for health plans. For example, plans with NCQA-accredited DM programs receive automatic credit on related managed care organization accreditation requirements.
Medicare+Choice, the Medicare managed care program, has suffered from helath plan withdrawals in recent year. Johnson described the type of proactive care needed in disease management. She added, "You can't do it with the old fee-for-service system."
Johnson legislation, introduced in late 2001, also would boost payments to health plans in M+C.
"Disease management is cost-effective," said Warren Todd, executive director of the Disease Management Association of America, and industry group that specializes in disease management.
In addition to NCQA, two other accreditation bodies, the American Accreditation HealthCare Commission (known as URAC) and the Joint Commission on Accreditation of HealthCare Organizations (JCAHO) have new disease management programs.
