DMAA: The Care Continuum Alliance Praises NAIC Recommendations on MLR Quality Improvement Component

Aug. 18, 2010 - PRLog -- WASHINGTON, D.C. - DMAA: The Care Continuum Alliance today praised recommendations from the National Association of Insurance Commissioners that wellness, prevention and chronic disease management should be counted as quality improvement activities in the medical loss ratio (MLR) formula.

The association, which represents organizations and individuals providing the breadth of programs and technologies to improve health and wellness and combat chronic disease, has strongly made the case that such services should be recognized as medical or quality improvement expenses in the MLR.

"The NAIC has done an exemplary job in an open and transparent way to ensure the MLR calculation recognizes the important services and products our members provide," DMAA: The Care Continuum Alliance President and CEO Tracey Moorhead said. "Preventing and managing chronic disease and keeping people well unquestionably improves quality, contributes significantly to improving health care outcomes and lowering health care costs for consumers."

DMAA: The Care Continuum Alliance has worked closely with the NAIC over the past several years, both before and during the recent process to craft an MLR definition consistent with the mandates of the Affordable Care Act (ACA). Throughout, DMAA: The Care Continuum Alliance has provided comment and documentation to support its position on the value of population health management and care coordination programs.

"These recommendations are well-aligned with ACA's overall emphasis on the importance of prevention, wellness and care coordination," Moorhead said. "We thank the NAIC for working with DMAA: The Care Continuum Alliance to ensure appropriate recognition of population health management in the MLR calculation and we are pleased to have contributed to this process."

"The success of health care reform hinges largely on our ability to effectively reduce risk of chronic disease, keep the healthy well and improve quality of life for the chronically ill," Moorhead said. "Recognizing these essential, evidence-based approaches to care as quality improvement in the MLR formula will aid efforts immeasurably to fight chronic disease."

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DMAA: The Care Continuum Alliance represents more than 200 organizations and individuals and convenes all stakeholders along the care continuum toward population health improvement. Through advocacy, research and promotion of best practices, DMAA advances population-based strategies to improve care quality and outcomes and reduce preventable costs for individuals with and at risk of chronic conditions.