Health plans' use of asthma quality improvement projects to meet NCQA accreditation standards

Background: Managed care represents an important system of healthcare delivery in the United States and the primary source of care for many persons with asthma. Objective: To characterize how US managed care health plans address the quality of asthma care through the use disease-specific quality improvement (QI) programs complying with National Committee for Quality Assurance (NCQA) standards. Methods: This study was a cross-sectional review of reports from all accreditation surveys conducted in 1996 and 1997 by the NCQA. Each accreditation report was reviewed for evidence of whether the health plan explored asthma care as a way to demonstrate compliance with NCQA accreditation standards. Asthma activity was examined with respect to health plan characteristics such as size of plan and Medicaid contracting. Types of asthma QI activity, use of guidelines, and application of different NCQA accreditation standards were also examined. Results: Approximately 90% of 197 health plans undergoing NCQA accreditation surveys in 1996 and 1997 reported some form of asthma QI activity. There were no statistically significant differences in this activity in large vs small plans or in plans with vs without Medicaid members. Approximately two thirds of health plans used asthma QI activities to meet NCQA accreditation standards in health management systems, and three fifths monitored and evaluated important aspects of asthma care and service. Conclusions: During the study period, many US health plans conducted asthma care QI activities. The recently released NCQA asthma performance measure may provide the next assessment of how well managed care is contributing to improving asthma care in the United States.