Printed from BusinessInsurance.com

LETTERS TO THE EDITOR: NCQA TO CERTIFY, NOT ACCREDIT, PHYSICIAN GROUPS

Posted On: May. 25, 1997 12:00 AM CST

To the editor: The May 12 article, "NCQA Expands Accreditation," about the National Committee for Quality Assurance's new Physician Organization Certification program, incorrectly indicates that we will begin to accredit physician organizations directly.

There is a subtle but important distinction between accreditation and the certification program for physician organizations we just announced.

Accreditation surveys involve an overall assessment of an organization's quality, including how well its various systems work together.

By contrast, certification surveys are less comprehensive and involve an analysis of selected systems only, such as utilization management, credentialing, quality improvement, members' rights and responsibilities, preventive health care and medical records.

NCQA's Physician Organization Certification program is designed to streamline our managed care organization accreditation process by reducing redundant oversight of physician groups. Indeed, certification is not meant as an overall assessment of the quality of a physician organization, and we want to make certain it is not interpreted in that way by employers, consumers or managed care plans.

David F. Arnold

Director of Product Development

National Committee

for Quality Assurance

Washington