Medicare Regulators to Require More Data About Care in HMOs
March 29, 2011
WASHINGTON -- Federal regulators plan to require health-maintenance organizations that cater to the elderly to disclose much more information about the quality of care that they provide. About 12% of the Medicare population, or 4.5 million people age 65 and over, belong to Medicare HMOs. That total is rising by 80,000 a month. Health plans have courted such members because the federal government pays premiums of as much as $700 a month for their care. While surveys have shown that many Medicare HMO members are satisfied with their care, concerns have arisen about the handling of some costly cases involving very sick members. ``We are working toward requiring plans to provide performance measures,'' said Bryan Eden, head of the office of managed care at the Health Care Financing Administration, the government agency that runs Medicare. Those yardsticks would affect nearly 200 HMOs that enroll Medicare members. At a news conference, Mr. Eden said he wasn't yet ready to declare that the federal government would endorse new HMO standards issued this week by the National Committee for Quality Assurance, a private health-care oversight group. But Mr. Eden repeatedly hinted that an announcement along those lines would be coming soon. The new NCQA standards call for HMOs to report more information on about 70 aspects of care, including preventive services, member satisfaction and treatment of patients with chronic illnesses. The reporting standards are voluntary, but HMOs often are asked by major employers to provide such data if they want to be offered as a health-plan choice for that company's employees.
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