Margaret O Kama Case Study

Margaret E. O’Kane is the founder and president of the National Committee for Quality Assurance (NCQA). NCQA is one of the nation’s leading advocates for improving healthcare through measurement, reporting, and accountability. NCQA is the foremost accrediting organization for health plans including HMOs, PPOs, and consumer directed plans. (Margaret) “Our goal is to increase the value of NCQA accreditation both to organizations pursuing accreditation and to the audiences who seek help in assessing the quality of health care provided by those organizations”. NCQA has developed, maintained, and expanded the nation’s most widely used health care quality tool, which is known as the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS is responsible for evaluating whether and how well

O’Kane explained that there was a general anger about managed care because it has changed physician’s incomes, it’s changed their autonomy, and its changed their relationship with their patients. She also explained the anger more specifically regarding the NCQA relating to accountability and evidence-based practice, and that they are very controversial in the physician community. O’Kane also explains to Managed Care how the fact that the plan to hold physicians accountable for quality is offensive to a profession that is not used to being accountable to others. O’Kane tells in her interview that she understands that the nature of this work is inherently controversial. “What we have to do is choose a sort of balance posture where we weigh scientific imperfection, which is the reality here, against creating potential damage in the marketplace because of scientific imperfection”.