Tennessee Health Care Quality Highlighted in National Report

Tennessee Health Care Quality Highlighted in National Report

National Committee for Quality Assurance (NCQA)Andy Reynolds, 202-955-3518

The new report from the National Committee for Quality Assurance (NCQA) features Tennessee as a state where health quality has taken center stage. The is NCQA’s annual analysis of the overall quality of American health care.

Eleven commercial health plans are accredited by NCQA and three of these (Aetna and CIGNA HMOs and the Blue Cross Blue Shield of Tennessee PPO) are rated Excellent- meaning they have high HEDIS®, CAHPS and accreditation scores. The Tennessee health plans are the highest rated among plans in the U.S. Department of Health and Human Services’ South Central region.

All four TennCare Medicaid plans are NCQA-Accredited, reflecting a state mandate that requires NCQA Accreditation; Amerigroup and Volunteer state plans are rated Excellent. Five Medicare plans are accredited, with Aetna and Cariten rated Excellent.

“The annual Report provides measure-by-measure results across the nation, but we are most excited to understand by looking at quality innovations at the local level,” said NCQA Vice President of Public Policy and Communications Sarah Thomas. “Tennessee is exemplifying as a state where purchasers, providers and health plans work together to improve quality.”

Not only are Tennessee’s health plans doing well in health quality, but the state is also making strides in the health care delivery. As of September 2012, 374 physicians in Tennessee are NCQA Recognized out of 23,078 nationally NCQA Recognized physicians. Blue Cross Blue Shield (BCBS) of Tennessee is a formal sponsor of the NCQA Patient-Centered Medical Home (PCMH) Recognition program, which pays health practices’ fees for onsite training and pays a fee to practices recognized for care management. When asked why the plan chose to support NCQA’s PCMH Recognition program, BCBS of Tennessee staff responded that it “enables and provides physicians with an effective roadmap to transform to a true patient-centered medical home. Our organization considers NCQA to be the leading authority on recognition of PCMH sites.”

One pioneering PCMH practice in Tennessee is Summit Medical Group. As the largest primary care practice in Tennessee, Summit has established three after-hours care centers in the Knoxville area, to improve access to care for patients. Better access to care can be instrumental in reducing emergency room visits and hospital readmissions.

“Summit is proud of our steady increases in the number of physicians earning NCQA Recognition. Since NCQA Recognition is based on outcomes, this progress is tangible proof of our quality,” explains Summit Medical Group Chief Medical Officer and Executive Vice President, Dr. Randy Curnow.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.