NCQA Awards Aetna “Excellent” Accreditation For Ohio HMO And Point-Of-Service (POS) Health Plans
CHICAGO, May 23, 2005 — Aetna (NYSE: ΑET) announced today that the National Committee for Quality Assurance (NCQA) has awarded its highest rating of "Excellent" Accreditation to Aetna’s HMO and Quality Point of Service (QPOS) plans in Ohio. NCQA awards "Excellent" Accreditation for service and clinical quality that meet or exceed NCQA’s rigorous requirements for consumer protection and quality improvement, including Health Plan Employer Data and Information Set (HEDIS®) results that are in the highest range of national performance.
Aetna’s "Excellent" Accreditation in Ohio follows on the heels of Aetna’s national achievement last January when NCQA recognized Aetna as an "early adopter" of Member Connections, NCQA’s new standards to measure how effectively health plans provide consumers with online tools and information to guide quality decision-making.
"Aetna believes in the power of information and is committed to providing members with quality and cost data they can use to make informed decisions about their health and financial well-being," said Allan Greenberg, regional president of Aetna’s North Central region. "This includes information about Aetna’s own performance, and we are proud to share that nationally 99.3 percent of Aetna’s HMO membership is enrolled in an NCQA accredited plan, with 93.5 percent enrolled in plans that have achieved an Excellent rating."
"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 the 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 purposefully set high to encourage health plans to continuously enhance their quality. No comparable evaluation exists for fee for service health care. 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?
The new NCQA Member Connection standards measure how effectively health plans provide consumers with tools and information to guide quality decision-making by:
- Leveraging the Web to help members with chronic conditions manage their care and improve outcomes
- Allowing members to track claims online
- Providing tools for members to assess and maintain their health, such as health risk appraisals
As one of the nation’s leading providers of health care, dental, pharmacy, group life, disability and long-term care benefits, Aetna puts information and helpful resources to work for its approximately 14.4 million medical members, 12.8 million dental members, 9.0 million pharmacy members and 14.0 million group insurance members to help them make better informed decisions about their health care and protect their finances against health-related risks. Aetna provides easy access to cost-effective health care through a nationwide network of more than 672,000 health care professionals, including over 400,000 primary care and specialist doctors and 4,084 hospitals. For more information, please visit www.aetna.com. (Figures as of March 31, 2005)
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