Aetna Is A Leader In Pursuing NCQA Accreditation For National PPO Plan
Quality data will inform health care purchaser decisions
HARTFORD, Conn., March 12, 2007 — Aetna (NYSE: ΑET) today announced a significant expansion of its commitment to collecting and providing information that plan sponsors and members can use to evaluate the quality of its health plans. Aetna is pursuing National Committee for Quality Assurance (NCQA) Preferred Provider Organization (PPO) accreditation at a national level, which means the accreditation will apply to health plan members in all 50 states. Currently, no national PPO plans hold NCQA accreditation.
"We recognize the need for consistent and externally validated assessment of the quality of our health plans, and we are eager to provide this information to our plan sponsor customers and our members," said Troyen Brennan, M.D., Aetna Chief Medical Officer. "By showing that we meet or exceed the most rigorous standards of service and care, we enable health plan purchasers to compare our plans against each other and against competing offerings so they can make the choice that best fits their needs. In addition, we can use this data to continuously improve the quality of our health plan offerings."
Accreditation for Aetna’s national PPO product will complement existing accreditation and performance data on Aetna’s HMO and POS products. Aetna anticipates the PPO product review in the third quarter of 2007, with results by the end of the year. This in-depth accreditation process will evaluate Aetna’s PPO product as a national entity with consistent national programs and processes. Typically, NCQA’s accreditation reviews have been conducted at a state level, and in some cases, at a regional level.
"Aetna’s choice to bring their PPO forward for NCQA Accreditation is a reflection of their commitment to meeting the toughest standards, being accountable to their members and responding to the demands of employers," said NCQA President Margaret E. O’Kane.
"I commend their decision, and look forward to other PPOs following Aetna’s lead."
During the review, Aetna will present information to NCQA regarding all facets of our health plan operations such as:
- Our health plan programs, clinical policies, network accessibility, and member satisfaction.
- Ways we help members through clinical programs, pharmacy management, and support and referrals associated with behavioral health issues.
- Our network credentialing process, and ongoing quality reviews to help demonstrate our members are receiving high quality, evidence-based care.
- Member rights; complaint and appeal handling; physician directories; member and marketing materials; privacy and confidentiality.
- And, our full suite of on-line consumer health tools including our Personal Health Record, health risk appraisals, claim and pharmacy information, and other Web-based consumer tools and functionality.
"We view this commitment to pursuing NCQA PPO accreditation as reflective of our continuing support for the Executive Order signed by President Bush in August 2006, which called for greater transparency in the health care system to support informed consumer health care decisions and value-based competition in health care," said Charles M. Cutler, M.D., Chief Medical Director, Aetna National Accounts. "Pursuing PPO accreditation joins a robust range of activities Aetna has undertaken to improve visibility into the quality of care our members receive, and the cost of that care."
About NCQA
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA is the nation’s leading developer of health care evaluation tools including health plan accreditation, physician recognition and organization certification. NCQA also is responsible for the evolution of HEDIS®, the most widely used set of health care performance measures. 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 choices. For more information, visit www.ncqa.org.
About Aetna
Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 35.9 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life, long-term care and disability plans, and medical management capabilities. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans and government-sponsored plans. www.aetna.com
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