PHOENIX, AZ, February 26, 2002 — (NYSE: ΑET) The National Committee for Quality Assurance (NCQA) has awarded Aetna U.S. Healthcare of Arizona "Excellent" Accreditation for its HMO and Quality Point-of-Service (QPOS) and USAccess plans. The "Excellent" level of distinction has been earned by only 54 percent of commercial health plans that have received NCQA accreditation as of January 31, 2002.
"It is rewarding to know that after a thorough review of Aetna's Arizona market, the industry's leading accrediting organization validates our pledge to provide access to quality of care and customer service," said Milton Schwarz, M.D., medical director for Aetna's West Region. "In addition to our ongoing commitment to quality, we have taken further actions to raise the bar on the level of service we provide to our members and provider networks. We are addressing health care issues by providing physicians with a choice in health plan participation and building our technology base to enhance our case management and disease management initiatives."
NCQA awards "Excellent" Accreditation, the highest possible level, for service and clinical quality that meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement and have Health Plan Employer Data and Information Set (HEDIS(r)1) results that are in the highest range of national performance.
"Earning Excellent Accreditation reflects a health plan's ability to work with their members and their physicians to improve the quality of clinical care," said Margaret E. O'Kane, President of NCQA. "It shows that they are building the kinds of partnerships that are critical to delivering great care and great service."
The NCQA Standards for Accreditation are purposely set high to encourage health plans to continuously enhance their quality. No comparable evaluation exists for fee-for service health care. To earn NCQA's "Excellent" designation, health plans are required to meet several discriminating criteria. Surveys include rigorous on-site and off-site evaluations of over 60 standards and selected HEDIS performance measures. Survey results are publicly reported and organized into the following five categories:
- Access and Service - Do health plan members have access to the care and service they need?
- Qualified Providers - Does the health plan assess each doctor's qualifications and what health plan members say about its providers?
- Staying Healthy - Does the health plan help members maintain good health and detect illness early?
- Getting Better - How well does the health plan care for members when they become sick?
- Living with Illness - How well does the health plan care for members when they have chronic conditions?
NCQA Accreditation not only involves a thorough review of a health plan's consumer protection and quality improvement systems, but also requires health plans to submit audited data on key clinical and service measures (e.g., mammography screening rates; cervical cancer screening; childhood immunizations).
"This accreditation tells our members that the care they receive and the physicians who provide that care meet or exceed the industry's highest standards of quality," said Linda Wilson, quality manager for Aetna's Arizona market. "Having NCQA award our HMO and POS plans an accreditation status of Excellent validates our ongoing commitment to work collaboratively with physicians, hospitals and administrative services toward the continuous improvement of these plans."
NCQA is the leader in the effort to assess, measure and report on the quality of care provided by the nation's managed care organizations. Of the approximately 650 HMOs in the country, approximately half have been reviewed by NCQA. Of the 256 total commercial plans accredited, only 139 or 54 percent have received an "Excellent" rating, as of January 31, 2002. NCQA also manages the HEDIS(r) process; the performance measurement tool used by more than 90 percent of the nation's health plans.
Aetna is one of the nation's leading providers of health care and related group benefits, serving 15.6 million health care members, 12.4 million dental members and 11.5 million group insurance customers, as of January 1, 2002. Information about Aetna is available at www.aetna.com.
1 HEDIS(r) is a registered trademark of the National Committee for Quality Assurance (NCQA).
