dress them. Also available is APEXPH in Practice (NACCHO, 1995a), which provides tools to facilitate use of APEXPH.

NACCHO recently published a profile of local health departments that presents, in the aggregate, information on their organization, resources, and activities (NACCHO, 1995b). NACCHO also plans to revise APEXPH , including enhancing the limited environmental health component.²⁰ NACCHO also is working through the Joint Council of Governmental Public Health Agencies on the role of state and local public health departments in issues of quality assurance and accountability as they affect population groups. Previously NACCHO collaborated with CDC to produce Blueprint for a Healthy Community (NACHO and CDC, 1994), which outlines 10 elements needed to protect and promote community health.

The National Committee for Quality Assurance (NCQA) focuses on quality in health care and on providing purchasers and consumers of health care services with information that helps them select among health plans offering those services. It uses accreditation to establish that health plans have structures and processes that should enable them to meet the needs of their enrolled populations.

NCQA has three aims for performance measurement. First, there should be national standardization of measures. Second, application of those measurement standards should be documented. Third, performance measurement should produce information that promotes quality improvement. NCQA is addressing these aims with HEDIS—the Health Plan Employer Data and Information Set—which provides a standard set of measures that helps purchasers compare health plans and helps health plans assess their own performance (NCQA, 1993).

NCQA is working with many health plans to help them improve their data collection and analysis capabilities for both external reporting and internal assessment. A pilot project involving 21 health plans with varying characteristics has demonstrated the feasibility of producing "report cards" but also has shown that the process is not easy. Work is also beginning on the HEDIS 3.0