Then compare the results to the other plans you are evaluating. Many independent accreditation organizations can certify that health plans have the structure in place to provide quality care. The field of accreditation is evolving quickly to keep pace with the growth of managed care. NCQA is one of the most established accreditation organizations for managed care plans. It's important that all doctors be certified by their specialty boards.
Most plans also have their own physician credentialing process.
Also, ask the plan how frequently doctors are re-credentialed. Finally, be sure to ask how many doctors have left the plan in the last year and why. Some plans link provider reimbursement to the quality of care they provide and to patient satisfaction survey results. This can create a strong incentive for doctors to make patient satisfaction and quality care a priority. Many plans manage patients' chronic health problems through disease management programs.