Press Releases October 8, 1999

The National Committee For Quality Assurance and Qualex Consulting Services Help America Choose A Better Health Plan

SAS helps employers and consumers choose higher quality managed health-care plans. The National Committee for Quality Assurance (NCQA) is a private, non-profit organization dedicated to improving health care by assessing and reporting on the quality of health plans. It successfully switched to SAS software to collect and process health care performance data submitted annually by more than 400 health plans.

“We needed a flexible system to support the collection, analysis, and reporting of performance data submitted by health plans,” said Pete Frawley, NCQA’s Director of Information Systems. “The challenge was to manage in the space of a few weeks the annual collection of quality-performance data files, including consumer survey satisfaction data. Health plans and satisfaction survey vendors submitted the data as Microsoft Excel worksheets and ASCII flat files. Plans submitted more than 3,000 files, which NCQA processed to validate the data, generate reports, and create extract files for information applications such as NCQA’s CD-ROM health plan information product, Quality Compass. An added challenge was to integrate HEDIS data with NCQA’s health plan accreditation program.

“We turned to the SAS System for the software and Qualex Consulting Services for the expertise to make it all work,” said Frawley.

Through products such as Quality Compass and its health plan accreditation program, NCQA provides audited performance data that allows purchasers and consumers of managed health care to distinguish among plans based on quality as well as price.

NCQA collects HEDIS (Health Plan Employer Data and Information Set) data, a set of standardized performance measures related to significant public health issues such as cancer, heart disease, smoking, asthma, and diabetes. HEDIS also includes a health plan member satisfaction survey.

The HEDIS Data Collection System (DCS), the SAS software application designed by NCQA and Qualex Consulting Services, was able to track and process HEDIS data submissions and make the data available quickly for analyses such as NCQA’s annual State of Managed Care report. The data was also processed for use in health plan report cards designed to compare plans based on quality.

Qualex Consulting Services implemented a solution with SAS/AF and Frame, using SAS/SHARE running on a Windows NT workstation as the server component, with Windows 95 and 98 workstations as clients. By using SAS/Share, the application allows NCQA’s health plan account managers to receive, load, process, validate, and report the health plan data submissions concurrently. The system loaded the data directly into SAS data sets designed for ease of analysis and reporting. NCQA processed the health plan performance data in less than half the time it took using a prior system developed in Access and Visual Basic as front ends to an SQL Server database. In the end, the system cost a third of the previous application, yet brought with it dramatic gains in efficiency and productivity.

“The system we had the previous year was too cumbersome to meet our objectives to turn around data quickly with maximum flexibility,” said Frawley. “It was set up as a fully-normalized database that might have been great as a banking transaction system, but what we needed was a system that allowed us to quickly analyze and report data, with flexibility to make a lot of iterative changes to programming code as we learned more about the data and implemented policy changes.

“We had previous experience with the SAS System and knew that it was the optimal choice for analysis and reporting. With the added capability of SAS/AF to automate functions such as loading and processing data by running modular SAS code, we decided to build the whole system as a seamless SAS application. An added goal was to be able to maintain and develop the system ourselves in future years.”

NCQA didn’t have the SAS/AF expertise to build the system, so they hired Qualex Consulting Services to take advantage of the extensive AF programming experience of Senior Consultant Chris Roper. “Chris and the other Qualex consultants were able to meet every challenge that arose and exceeded all my expectations for responsiveness,” Frawley said. “They were totally committed to the success of this project and showed unparalleled professionalism and dedication.”