Quality Plus is a voluntary program for NCQA-Accredited organizations. Aetna’s California HMO plan currently has an Excellent Accreditation rating.
Member Connections standards assess how effectively organizations interact with their members via the Web and telephone to make sure they understand and know how to use their benefits, have access to self-management tools for certain conditions and can check on the status of claims.
Care Management and Health Improvement Standards build on existing chronic care and disease management standards in the MCO Accreditation Program.
Physician and Hospital Quality standards evaluate how health plans measure the quality and cost of care provided by network physicians and hospitals. Purchasers have expressed a strong desire for such information.
"Aetna is to be commended for meeting all of our new Physician and Hospital Quality standards," said NCQA President Margaret E. O’Kane. "By adopting these standards Aetna is providing members with important information about physicians and hospitals within their network, allowing them to make better health care decisions for themselves and their families."
Milton Schwarz, M.D., regional medical director for Aetna’s West region, said, "We are pleased to have earned the Quality Plus Distinction from NCQA, which demonstrates Aetna’s commitment to improving health care quality, and to providing members with relevant information to help guide their health care decisions."
"Aetna has been at the forefront of health care transparency, demonstrated through our own initiatives, and through our collaboration with the California Hospital Assessment and Reporting Taskforce (CHART) and the Integrated Healthcare Association (IHA) Pay for Performance program. This Distinction is another important component of the comprehensive cost and quality information we provide to our members and customers," Schwarz added.
Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 36.7 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 and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. www.aetna.com