UnitedHealthcare Achieves NCQA Physician and Hospital Quality Distinction

UnitedHealthcare, a UnitedHealth Group (NYSE:UNH) company, is one of the first national health plans to achieve the Quality Plus Distinction for Physician and Hospital Quality (PHQ) from the National Committee for Quality Assurance (NCQA).

Quality Plus is a voluntary program for all NCQA-accredited organizations that evaluates how well a commercial health plan complies with standards in three categories: Member Connections; Care Management and Health Improvement; and Physician and Hospital Quality. With PHQ achievement, UnitedHealthcare now holds all three NCQA Quality Plus distinctions in markets that service more than 17 million customers.

According to NCQA, PHQ standards are focused on four areas:

• Standardization: NCQA supports standardized measures of physician and hospital quality; where it is not possible, it encourages the drive toward standardization. Quality and resource use measures must be evidence-based, reliable and valid.
• Transparency: These standards require that specifications measuring physician and hospital performance be available to the organizations being measured and the public.
• Collaboration: These standards encourage collaboration among plans by streamlining the review process for organizations participating in collaborative measurement initiatives. The standards also support collaboration between plans and providers – a key to successful measurement activities.
• Action: The objective of measurement is quality improvement and affordability. Health plans should take specific actions to improve performance, such as reporting and engaging in quality improvement activities or using payment and product design strategies.

“By meeting NCQA Physician and Hospital Quality standards, UnitedHealthcare has demonstrated it provides its health plan participants with important information about physicians and hospitals within its network, thus enabling consumers to make better health care decisions for themselves and their families,” said NCQA President Margaret E. O’Kane.

Sam Ho, M.D., UnitedHealthcare’s executive vice president and chief medical officer, said: “At UnitedHealthcare, we believe that by partnering with physicians we can develop health care information programs - using standardized, evidence-based care and claims data - that enable consumers and our employer customers to make better, more informed decisions. We welcome independent review of our programs, which helps us ensure our customers have access to meaningful information they can use to help them lead healthier lives.”

NCQA’s Distinction standards are intended to help organizations like UnitedHealthcare achieve the highest level of performance possible by measuring programs to improve health outcomes, patient connectivity and disclosure of provider performance as well as create an environment of continuous improvement.

The UnitedHealth Premium physician designation program, which builds on UnitedHealthcare’s 10-plus years of assessing physician and hospital performance, analyzes physician practices based on established and accepted clinical guidelines for quality care. Available online at www.uhc.com, the UnitedHealth Premium physician designation program enables UnitedHealthcare customers to compare quality and cost-efficiency information for physicians and facilities within their communities. The program gives more than 17 million UnitedHealthcare plan participants access to this information.

The PHQ distinction was previously earned by PacifiCare of California, a UnitedHealthcare company. The NCQA distinction for that plan was based on UnitedHealthcare Quality Index Profiles for Medical Groups and Hospitals, which include quality, cost and efficiency measures that consumers can use to select medical groups. The results are incorporated into the Quality Incentive Program for delegated medical groups.

About NCQA

NCQA is an independent, not-for-profit organization dedicated to measuring the quality of America’s health care. Consumers can access an organization’s NCQA Distinction status and other information on health care quality at www.ncqa.org/reportcards.aspx.

About UnitedHealthcare

UnitedHealthcare (www.unitedhealthcare.com) provides a full spectrum of consumer-oriented health benefit plans and services. The company organizes access to quality, affordable health care services on behalf of more than 25 million individual consumers, contracting directly with more than 560,000 physicians and care professionals and 4,800 hospitals nationwide to offer them broad, convenient access to services nationwide. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE:UNH), a diversified Fortune 50 health and well-being company.