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Where Are These Measures?
Today, you can find a great deal of information about health care quality. And much more is on the way. Here is a brief look at what is available now and where you can find it.
Quality reports include consumer ratings, clinical performance measures, or both. These reports go by different names, including report cards and performance reports. Quality reports can help you select the right treatment, based on the things that are most important to you. You may be able to get quality reports from:
- Your employer. Ask your personnel office for information on the plan or plans that are offered.
- Health plans. Ask the plan's customer service office.
- Other health care providers, such as hospitals, nursing homes, or community health clinics.
If you need help, check with your local library or your local or State department of health. You can find your State department of health listed in the blue pages of your phone book.
Also, look for these quality reports, which are based on consumer ratings from CAHPS®:
- For quality reports about Medicare managed care plans, call 1-800-MEDICARE, or look for Medicare Compare at http://www.medicare.gov (Medicare Compare is also based on HEDIS).
- For quality reports about Federal employee health plans, visit the Office of Personnel Management Web site at http://www.opm.gov/insure/index.html.
Another type of quality measurement is accreditation. Accreditation is a "seal of approval" given by a private, independent group. Health care organizations must meet national standards—including clinical performance measures—to be accredited. Some organizations, such as group practices, do not have such a program available. Accreditation is done by a number of groups. Some of them are:
- The National Committee for Quality Assurance (NCQA). NCQA evaluates and accredits managed care plans. Call 888-275-7585 to find out if a health plan is accredited. Or call 800-839-6487 to ask for accreditation information. NCQA's Web address is http://www.ncqa.org.
- Joint Commission on Accreditation of Healthcare Organizations. JCAHO evaluates and accredits hospitals, health care networks, and managed care organizations. JCAHO also accredits health care organizations that provide home care, long-term care, behavioral health care, and laboratory and ambulatory care services. For information, visit Quality Check (http://www.jcaho.org/quality+check/index.htm) on JCAHO's Web site, or call (630) 792-5000.
- American Accreditation HealthCare Commission/URAC. This group develops accreditation standards and programs for managed care. Call
(202) 216-9010 for information on accredited organizations, or visit URAC's Web site (http://www.urac.org/accredited.htm).
- Community Health Accreditation Program. CHAP evaluates and accredits home health care organizations. To find out more, call CHAP at 800-669-9656, ext. 242, or visit CHAP's Web site (http://www.chapinc.org/chap-consumer.htm).
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