CRITERIA for evaluating health maintenance organizations (HMOs) have shifted from price to performance. The managed care plans that used to attract contracts based on cost and coverage now find that purchasers are asking more about the quality of the services they offer and how well they perform. Increasingly, the answer comes from reviews by the National Committee for Quality Assurance (NCQA).
Margaret E. O'Kane is president of the Washington, DC—based nonprofit organization that is devoted to assessing and reporting on the quality of managed health care plans. The NCQA was formed in 1979 by the managed care industry and the Group Health Association, partly to obviate a federal monitoring system for managed care organizations (MCOs); it became independent in1990, aided by a grant from the Robert Wood Johnson Foundation. Today, most of the NCQA's income is from fees, averaging $40 000 per plan, charged for performing accreditation reviews. Other funds