MCPR 2000 - Measuring the Quality of Pennsylvania's HMOs - Related Links

PHC4 Links

PHC4 has released other reports on health care in Pennsylvania. The following links provide access to the most recent related reports and newsletters:

Additional Links

Various other organizations present information on their websites related to Commercial HMOs and the diseases contained in PHC4's Commercial HMO Report. The information may be directed toward consumers, health care professionals, researchers, or a combination of these groups. The following sites are a sampling of some of the information that is available.

Pennsylvania Department of Health
The Pennsylvania Department of Health reviews quality and access standards and monitors grievances and grievance procedures for HMO patients. It sets guidelines for benefits, provider networks, reporting, and quality assurance. The Department of Health also requires HMOs in Pennsylvania to undergo an external quality review.

Pennsylvania Insurance Department
The Insurance Department monitors the financial strength of HMOs to ensure that the organization has sufficient resources to deliver promised health care services. It also approves rates, rating structures, and marketing practices.

Agency for Healthcare Research and Quality
The Agency for Healthcare Research and Quality (AHRQ) research provides evidence-based information on health care outcomes; quality; and cost, use, and access. Its mission is to support research designed to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors, and broaden access to effective services. The research sponsored, conducted, and disseminated by the Agency for Healthcare Research and Quality (AHRQ) provides information that helps people make better decisions about health care.

American Cancer Society
The American Cancer Society (ACS) is a nationwide, community- based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy, and service.

American Diabetes Association
The American Diabetes Association is a nonprofit health organization whose mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. To fulfill this mission, the American Diabetes Association funds research, publishes scientific findings, provides information and other services to people with diabetes, their families, health care professionals and the public.

American Heart Association
The American Heart Association is a national voluntary health agency whose mission is to reduce disability and death from cardiovascular diseases and stroke. The agency works to provide effective, credible information to prevent and treat cardiovascular diseases and stroke, with a strong emphasis on those at risk.

American Lung Association
The American Lung Association ® (ALA) is a non-profit organization that works to fight lung disease in all of its forms, with special emphasis on asthma, tobacco control and environmental health. ALA is funded by contributions from the public, along with gifts and grants from corporations, foundations and government agencies.

American Medical Association
The AMA is a professional and advocacy organization for the medical profession. It work includes the development and promotion of standards in medical practice, research, and education; strong advocacy agenda on behalf of patients and physicians; and the commitment to providing timely information on matters important to the health of America.

Centers for Disease Control and Prevention (CDC)
The CDC is recognized as the lead federal agency for protecting the health and safety of people - at home and abroad, providing credible information to enhance health decisions, and promoting health through strong partnerships. CDC serves as the national focus for developing and applying disease prevention and control, environmental health, and health promotion and education activities designed to improve the health of the people of the United States.

Health Care Financing Administration (HCFA)
HCFA is the federal organization that administers Medicare and Medicaid. The official website offers information about programs, statistical highlights and the full text of laws and regulations affecting the agency.

Health Plan Employer Data and Information Set (HEDIS ®)
Sponsored, supported and maintained by NCQA, HEDIS is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare the performance of managed health care plans. The performance measures in HEDIS are related to many significant public health issues such as cancer, heart disease, smoking, asthma and diabetes. HEDIS also includes a standardized survey of consumers' experiences that evaluates plan performance in areas such as customer service, access to care and claims possessing.

Joint Commission for the Accreditation of Healthcare Organizations (JCAHO)
JCAHO, which is an independent, not-for profit organization, is nation's predominant standards-setting and accrediting body in health care. Since 1951, JCAHO has developed professionally based standards and evaluated the compliance of health care organizations against these benchmarks. It reviews and accredits hospitals and other health care organizations as well as accredits managed care organizations, as part of their network accreditation program.

National Committee for Quality Assurance (NCQA)
NCQA is an independent, 501(c)(3) non-profit organization whose mission is to improve health care quality everywhere. Dedicated to assessing and reporting on the quality of managed care plans, it is governed by a Board of Directors that includes employers, consumer and labor representatives, health plans, quality experts, policy makers, and representatives from organized medicine. NCQA reviewers evaluate how well a plan manages its quality improvement process as well as other aspects of service delivery.

National Heart, Lung and Blood Institute
The National Heart, Lung, and Blood Institute (NHLBI) is the section of the National Institutes of Health (a federal government agency) that provides leadership in diseases of the heart, blood vessels, lung, and blood, as well as blood resources and sleep disorders. The Institute plans, conducts, fosters, and supports an integrated and coordinated program of basic research, clinical investigations and trials, observational studies, and demonstration and education projects.

National Institute of Diabetes & Digestive & Kidney Diseases
The National Institute of Diabetes and Digestive and Kidney Diseases conducts and supports research on many of the most serious diseases affecting public health. The Institute supports much of the clinical research on the diseases of internal medicine and related subspecialty fields as well as many basic science disciplines.

National Mental Health Association
The National Mental Health Association (NMHA) is the country's oldest and largest nonprofit organization addressing all aspects of mental health and mental illness. NMHA works to improve the mental health of all Americans through advocacy, education, research and service.