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39 Health Plans Pledge Early Participation in NCQA's New 'Quality Plus' Program

Posted on: Wednesday, 12 January 2005, 15:00 CST

WASHINGTON, Jan. 12 /U.S. Newswire/ -- The National Committee for Quality Assurance (NCQA) today announced that 39 health plans nationwide (see list below), collectively covering more than 11.5 million Americans, have committed to undergo surveys under the first of set of NCQA's new "Quality Plus" standards, titled Member Connections. These standards focus on the depth, accuracy and interactivity of the information health plans provide their members in order to best help them manage their own health.

"It's gratifying that so many HMOs and PPOs have opted to be reviewed against the Member Connections standards, to demonstrate how they make it easy for members to access information and stay involved in their care," said NCQA President Margaret E. O'Kane. "Members who take advantage of the decision-making support that these plans provide will be more engaged with their care-and happier with their plan."

Member Connections is the first step in NCQA's effort to update its accreditation programs, so that the same standards apply to a broader array of plan types. The standards assess how effectively an organization interacts with its members via the Web and telephone to help them understand benefits, access self- management tools for certain conditions and check the status of their claims. Effective engagement of consumers and patients in these ways, coupled with quick, clear responses to inquiries from plan enrollees, can have a dramatic impact on member satisfaction. The final standards for Member Connections will be released at the end of January; surveys will begin on July 1.

Many health plans welcomed the opportunity to be among the first organizations evaluated. "As consumers take a more active role in their health care, they need tools and information to support informed decision-making," said Charles M. Cutler, M.D., M.S., National Medical Director for Quality Management, Aetna. "The Member Connections standards support the needs of consumers in all types of benefit plans, particularly consumer-directed health plans, and as such, they encourage consumers to get involved in their health care. We look forward to making the results available to Aetna members and consumers."

"We want to make it easier for our members to make well- informed decisions about their health care. That includes helping them understand their benefits, and helping them learn how to stay healthy," said Dominic Galante, M.D., Vice President, Medical Quality Management for Preferred Care of Rochester, N.Y. "We pride ourselves on providing a high level of service to our members. Through the Quality Plus program, we look forward to further demonstrating that we meet and exceed the expectations of our Preferred Care customers."

Large employers helped develop the new standards and many are expected to require health plans serving their employees to seek the additional distinction of meeting them. Among the large employers expressing support for the new standards were NCR Corporation, Verizon and the Pacific Business Group on Health. "There is a direct correlation between how good your health plan is and how happy your employees are," said Michael Kriner, Director, Global Benefits, NCR Corporation. "We know those health plans that can meet NCQA's Member Connections standards will provide the highest level of service to their members. Differentiating health plans based on quality benchmarks is absolutely critical in an environment of rising health care costs. If our employees are happy with their health plan, we know that we're going to be a more competitive organization."

"Purchasers applaud the health plans that have demonstrated their commitment to innovation by stepping up to voluntarily participate in Quality Plus," said Peter Lee, J.D., President and CEO, Pacific Business Group on Health. "We're thrilled that NCQA has developed these new standards that will allow consumers and purchasers to identify plans from across the industry that are taking concrete steps to ensure consumers have the tools they need to control their own health care."

The Quality Plus program is a voluntary component of NCQA's Accreditation programs for HMOs, PPOs and point-of-service plans. Its purpose is to identify those organizations that provide information about the quality of doctors and hospitals, help members make decisions about their own health, take innovative approaches to chronic condition management and keep their members healthy. Quality Plus standards are designed to provide consumers and employers with a basis for comparing different types of plans, including HMOs, PPOs and consumer-directed health plans (CDHPs). Large employers and consumer groups have endorsed the program.

Standards for two other new content areas, Physician and Hospital Quality and Health Improvement, will be released for public comment in March. Those plans that meet the standards in any or all of the three Quality Plus content areas will be recognized on NCQA's Health Plan Report Card, available at http://www.healthchoices.org. Plans will also receive a seal acknowledging their distinction in the Member Connections program for placement on their Web site.

HMO AND PPO PLANS PARTICIPATING IN QUALITY PLUS:

1. Aetna Health, Inc. (NY)

2. Aetna Health, Inc. - Arizona (AZ)

3. Aetna Health, Inc. - Colorado (CO)'

4. Aetna Health, Inc. - Connecticut (CT)

5. Aetna Health, Inc. - DC, MD and VA (MD)

6. Aetna Health, Inc. - Delaware (DE)

7. Aetna Health, Inc. - Florida (FL)

8. Aetna Health, Inc. - Georgia (GA)

9. Aetna Health, Inc. - Maine (ME)

10. Aetna Health, Inc. - Massachusetts (MA)

11. Aetna Health, Inc. - Missouri (MO)

12. Aetna Health, Inc. - Northern New Jersey (NJ)

13. Aetna Health, Inc. - Ohio (OH)

14. Aetna Health, Inc. - Oklahoma (OK)

15. Aetna Health, Inc. - Pennsylvania (PA)

16. Aetna Health, Inc. - Southern New Jersey (NJ)

17. Aetna Health, Inc. - Tennessee (TN)

18. Aetna Health, Inc. - Texas (TX)

19. Aetna Health of California, Inc. (CA)

20. Aetna Health of Illinois, Inc. (IL)

21. Aetna Health of the Carolinas, Inc. (NC)

22. Blue Cross and Blue Shield of Massachusetts, Inc. (MA)

23. Blue Cross and Blue Shield of Massachusetts, Inc. (PPO) (MA)

24. Blue Preferred (PPO) (MD)

25. CareFirst BlueChoice (MD)

26. Group Health Cooperative (WA)

27. HealthPlus of Michigan, Inc. (MI)

28. Kaiser Foundation Health Plan of the Northwest, Inc. (OR)

29. Keystone Health Plan East, Inc. (PA)

30. Medical Mutual of Ohio (OH)

31. Medical Mutual of Ohio (PPO) (OH)

32. QCC Insurance Company (PersonalChoice) (PPO) (PA)

33. Rochester Area HMO d/b/a Preferred Care (NY)

34. UnitedHealthcare of Colorado (CO)

35. UnitedHealthcare of New England, Inc. (MA)

36. UnitedHealthcare of New Jersey, Inc. (NJ)

37. UnitedHealthcare of New York, Inc. (NY)

38. UnitedHealthcare of the Midwest, Inc. (MO)

39. UnitedHealthcare of Wisconsin, Inc. (WI)

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NCQA is an independent, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and offers recognition programs for physicians and physician groups. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health care choices.

http://www.usnewswire.com

Source: U.S. Newswire

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