Washington, D.C. - Insurers should offer consumers better information about consumer-driven health plans and other benefit plans, according to a report issued by the National Committee for Quality Assurance, a nonprofit organization that provides information on the quality of the nation's managed care plans. In a recently released white paper the Washington-based NCQA accredits health insurers for meeting certain standards of performance.
The white paper comes as enrollment in consumer-driven plans has risen sharply. America's Health Insurance Plans, a trade association also based in Washington, estimates enrollment in such plans hit 3.1 million in January 2006, compared with 438,000 in September 2004.
Most consumer-driven plans are a form of PPO, according to AHIP. Consequently, the NCQA white paper recommends that accreditation organizations develop more detailed standards for PPOs to support comprehensive assessment of their quality.
Accreditation organizations--including NCQA--also should establish standards covering how well health plans provide enrollees with cost and quality data, and provide decision support to aid enrollees in treatment decisions, according to the NCQA white paper.
Further, the paper recommends that governmental insurance regulators revise standards so all risk-assuming entities performing similar functions--such as HMOs and PPOs--are regulated identically. Regulators also should ensure that health plans make objective cost and quality information available to enrollees, and monitor how well consumers understand and use the information.
The white paper, "Protecting Consumers in an Evolving Health Insurance Market," is available at ncqa.org.
Source: National Committee for Quality Assurance
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