Provider board certification or residency completion
Arrangements with public health, educational, and social service organizations
Denotes testing set measures.
SOURCE: NCQA, 1998a.
The HEDIS cancer quality indicators have targeted early detection and diagnosis, not care received after cancer is diagnosed. NCQA's focus on early detection in cancer quality assessment appears to be related to its belief that ''early detection remains the most effective way of improving the outcomes of breast cancer'' (McGlynn, 1996). Treatment-related indicators are being evaluated—for example, assessment of the effect of breast cancer therapy on a woman's ability to function and patients' satisfaction with breast cancer treatment. NCQA has halted further work on the indicator related to the stage at which breast cancer is detected, because the incidence of breast cancer cases in most health plans is too low to make meaningful comparisons of stage at diagnosis across health plans (Schuster et al., 1998).
HEDIS is a voluntary system, although managed care plans are finding it increasingly necessary to participate to compete for patients. Some evidence suggests that most large employers are