Systems for Monitoring Quality of Community Healthcare in Israeli Health Plans and US Managed-Care Organizations

This study compares quality-monitoring systems in Israeli health plans and US managed-care organizations (MCOs). The Israeli system has been in place since 2000; the US system – since 1996.

The study relied on the annual reports of the National Quality Measures Program (NQMP) in Israel and of the National Committee for Quality Assurance (NCQA) in the US, on additional information available on the projects’ websites, and on interviews with professionals involved in the development and operation of the monitoring systems.

The main findings were:

The programs are similar in their focus on the quality of community care for common health problems and their reliance on inclusive steering committees and auditing processes. They differ in the proportion of the population covered, the main sources of data, and the extent to which they release their findings to the public. Participation in both programs was initially voluntary, and continues to be fully so in Israel and largely so in the US. The Israeli system provides a more detailed scrutiny of the care of patients with diabetes mellitus and cardiovascular diseases, while the US system includes a wider range of measurement areas.

It is recommended that consideration be given to (a) expanding monitoring over a broader range of measurements in Israel and over more health plans in the US, and (b) exploring the actions that health plans in Israel and the US have initiated to improve quality in response to the findings of their monitoring systems.

The study uniquely benefited from the inclusion of professionals who have been involved in leading the quality-monitoring efforts in the two countries.

Citations in the professional and academic literature

Nissanholtz-Gannot, R., & Rosen, B. (2012). Monitoring quality in Israeli primary care: The primary care physicians’ perspective. Israel journal of health policy research1(1), 26.

Tasher, D., Rubin, L., Grossman, Z., Grotto, I., Dahan, D., Berlowitz, Y., & Somekh, E. (2016). Child health care in Israel. The Journal of pediatrics177, S107-S115.