Oakland -- Kaiser Permanente’s Care Management Institute (CMI) is one of the first organizations in the United States to earn disease management (DM) certification from the National Committee for Quality Assurance (NCQA). The two-year NCQA DM Certification was awarded in program design. *

“Earning NCQA’s Disease Management Certification is a reflection of the vision, collaboration, and quality performance of everyone at Kaiser Permanente who strives to improve care for our members with chronic illness,” says George C. Halvorson, Kaiser Foundation Health Plan Chairman and CEO. “The Care Management Institute is to be commended for providing the leadership for this outstanding achievement.”

The program design certification was awarded for four areas: diabetes, asthma, heart failure, and depression. CMI was one of 18 “early adopters” to apply for the NCQA certification/accreditation.

Early participants in NCQA’s new program include the nation’s largest DM organization, several of the world’s largest pharmaceutical manufacturers, a hospital system, leading HMOs, and a specialty DM provider.

“Earning NCQA Disease Management Certification indicates that a DM program excels in the specific area in which it was reviewed, either program design, patient outreach, or DM systems,” says Margaret E O’Kane, NCQA President. “It’s an accomplishment to be proud of.”

Says Jed Weissberg, MD, CMI Board Chair and the Permanente Federation’s Associate Executive Director for Quality and Performance Improvement: “NCQA DM Certification recognizes our evidence-based approach to developing population guidelines for care. The long-standing relationship with NCQA contributed to our seeking early-adopter status and the quality of our work and our staff ensured that we would be successful. It is our hope that this certification reduces the burden of managed care organization (MCO) accreditation activity for our regional health plans as we continue to improve care for our 8.4 million members.”

Adds CMI Executive Director Paul Wallace, MD: "I believe we should engage in certification and accreditation processes for two reasons. The first is the obvious opportunity to represent to our customers and to ourselves that we do exemplary work. More importantly, by disciplining ourselves to reflect and summarize for others what we are doing now, imagining what can be done better in the future is inescapable; it is a compelling stimulus to continue to improve. I'm very pleased we are now recognized by NCQA. I am also confident we will do our work better for having gone through this process."

NCQA looked at CMI’s process for developing guidelines, including the evidence tables and the literature search, as well as the process structure – who was on the committees to design the guidelines, whether there were enough clinicians and the appropriate kinds of clinicians. They also looked at how the models of care were designed and developed.

NCQA looked at how the disease management work integrated with national programs, patient safety programs, and special populations. They also reviewed whether CMI received money from outside sources for this work (it does not), and if so, whether there was disclosure.

Kaiser Permanente is America's leading integrated health care organization. Founded in 1945, it is a non-profit, group-practice prepayment program with headquarters in Oakland, California. Kaiser Permanente serves the health care needs of 8.4 million members in 9 states and the District of Columbia. Today, it encompasses Kaiser Foundation Health Plan, Inc.; Kaiser Foundation Hospitals; and the Permanente Medical Groups, as well as an affiliation with Group Health Cooperative based in Seattle.

* NCQA has reviewed and certified Kaiser Permanente Care Management Institute’s Program Design Capability.