There is little consensus on how to define and measure quality health care. Research in this area is in its early stages and is often influenced by special interest groups like insurance companies, hospital organizations or doctors groups. One way of evaluating quality is through the use of accreditation reviews.
Accreditation is voluntary but health care organizations have reason to seek accreditation.
For example, some employers and unions require that plans covering their employees and members be accredited. What follows is information on accreditation organizations and other quality assessment tools that can be helpful in evaluating managed care plans. The National Committee on Quality Assurance is an independent non-profit organization that conducts accreditation reviews of managed care plans, mostly HMOs. NCQA evaluates how well a health plan manages its network. Evaluators look at whether a plan has safeguards in place to protect patients, how effectively a plan monitors the care provided, and how a plan uses the information it gathers to improve health care for its members.