shreyadas

Par 100 posts (V.I.P)
The NCQA is a national non-profit organization dedicated to providing standards for managed care health organizations. They began accrediting managed care organizations (MCOs) in 1991 in response to the need for standardized, objective information about the quality of these organizations. More than half the HMOs in the nation, covering have been reviewed by NCQA. Many large employers will not do business with a health plan that has not earned NCQA's seal of approval. 30 states recognize NCQA accreditation as meeting certain regulatory requirements for health plans, eliminating the need for a separate state review.
There are also a large number of MCOs that choose not to participate. Non participants include about 130 plans as of nine months ago, some with hundreds of thousands of members. In actuality, there are far more than 130, but NCQA counts only those with more than 8,000 members. Many of the larger plans are unaccredited. Some send NCQA data but refuse to allow their numbers to be publicly released and so are considered non-reporters by NCQA.
The question is whether or not lack of participation is indicative of mediocre performance. NCQA believes so. Among commercial plans, for example, non-reporters were on average 20 percent less effective at helping members who need to dramatically cut their cholesterol. Unaccredited Medicaid plans fell 14 percent short in providing appropriate asthma medication for children ages 5 to 9. These are a couple of examples from a very complicated matrix, but the pattern is clear. When you're looking for a provider, look for accreditation.


Implementing QA/QC procedures requires resources, expertise and time. In developing any QA/QC system, it is
expected that judgements will need to be made on the following:
• Resources allocated to QC for different source categories and the compilation process;
• Time allocated to conduct the checks and reviews of emissions estimates;
• Availability and access to information on activity data and emission factors, including data quality;
• Procedures to ensure confidentiality of inventory and source category information, when required;
• Requirements for archiving information;
• Frequency of QA/QC checks on different parts of the inventory;
• The level of QC appropriate for each source category;
• Whether increased effort on QC will result in improved emissions estimates and reduced uncertainties;
• Whether sufficient expertise is available to conduct the checks and reviews.
In practice, the QA/QC system is only part of the inventory development process and inventory agencies do not
have unlimited resources. Quality control requirements, improved accuracy and reduced uncertainty need to be
balanced against requirements for timeliness and cost effectiveness. A good practice system seeks to achieve
that balance and to enable continuous improvement of inventory estimates.
Within the QA/QC system, good practice provides for greater effort for key source categories and for those
source categories where data and methodological changes have recently occurred, than for other source
categories. It is unlikely that inventory agencies will have sufficient resources to conduct all the QA/QC
procedures outlined in this chapter on all source categories. In addition, it is not necessary to conduct all of these
procedures every year. For example, data collection processes conducted by national statistical agencies are not
likely to change significantly from one year to the next. Once the inventory agency has identified what quality
controls are in place, assessed the uncertainty of that data, and documented the details for future inventory
reference, it is unnecessary to revisit this aspect of the QC procedure every year. However, it is good practice to
check the validity of this information periodically as changes in sample size, methods of collection, or frequency
of data collection may occur. The optimal frequency of such checks will depend on national circumstances.
While focusing QA/QC activities on key source categories will lead to the most significant improvements in the
overall inventory estimates, it is good practice to plan to conduct at least the general procedures outlined in
Section 8.6, General QC Procedures (Tier 1), on all parts of the inventory over a period of time. Some source
categories may require more frequent QA/QC than others because of their significance to the total inventory
estimates, contribution to trends in emissions over time or changes in data or characteristics of the source
category, including the level of uncertainty. For example, if technological advancements occur in an industrial
source category, it is good practice to conduct a thorough QC check of the data sources and the compilation
process to ensure that the inventory methods remain appropriate.
It is recognised that resource requirements will be higher in the initial stages of implementing any QA/QC
system than in later years. As capacity to conduct QA/QC procedures develops in the inventory agency and in
other associated organisations, improvements in efficiency should be expected.
General QC procedures outlined in Table 8.1, Tier 1 General Inventory Level QC Procedures, and a peer review
of the inventory estimates are considered minimal QA/QC activities for all inventory compilations. The general
procedures require no additional expertise in addition to that needed to develop the estimates and compile the
inventory and should be performed on estimates developed using Tier 1 or higher tier methods for source
categories. A review of the final inventory report by a person not involved in the compilation is also good
practice, even if the inventory were compiled using only Tier 1 methods. More extensive QC and more rigorous
review processes are encouraged if higher tier methods have been used. Availability of appropriate expertise
may limit the degree of independence of expert reviews in some cases. The QA/QC process is intended to ensure
transparency and qualit

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